Working in breast cancer research: Rachel Rolph

Rachel Rolph is the Chief Investigator of the Restore B trial, a University of Oxford study into whether mesh should be used in breast reconstruction after surgery for breast cancer. It is currently recruiting volunteers in London (The Royal Marsden NHS Foundation Trust and University College London Hospitals NHS Foundation Trust), Oxford, Portsmouth and Reading.

What is this research study about? What health issue is it addressing?

Breast cancer is common, affecting 1 in 7 women in their lifetime. Some women will be offered a mastectomy as a way of treating their breast cancer or to reduce their overall breast cancer risk. These women will be offered breast reconstruction with either their own tissue or with an implant.

Recently, surgeons have been using a surgical device called mesh to wrap the implant in breast reconstruction. We do not have high quality research to tell us if using the mesh is beneficial or not to the patient. Surgical mesh has become a field of research interest after patient advocacy on the use of gynaecological pelvic mesh leading to the Cumberlege report, which emphasised the need for high quality research to support the use of mesh.

Our study is looking to randomise women to have their implant breast reconstruction either with mesh or without mesh. Breast reconstruction is possible without mesh, however we do not know which technique is better. Restore-B is a feasibility study to find out if patients and surgeons are willing to recruit to this study to see if it is possible to run a larger scale trial to answer the question if mesh in breast reconstruction is beneficial, neutral or detrimental to a patients’ breast reconstruction surgery. The Restore-B study is a multi-centre national study and is open to recruitment.

What does taking part involve?

Women who are due to have a mastectomy with immediate breast reconstruction with mesh are invited to participate. The study involves filling in a pre-operative quality of life questionnaire online and on the day of surgery the surgeon will randomise the participant to either have an implant based breast reconstruction with or without mesh. Participants will not initially know which of these they have been assigned to. This will be revealed to the participant by their surgeon at the 3 month follow up appointment.

In the post-operative period, participants are asked to fill in a quality of life questionnaire at 3 months and a weekly online post operative diary to tell us how their recovery is going. There are 2 sub-studies that women can also participate in. One is an online interview to discuss their views on mesh in breast reconstruction and the design of the study. The second involves an appointment in Portsmouth to have pre and post-operative breast movement data collected to help understand the changes in breast dynamics after this surgery.

What motivates you to work in research?

I have always had a passion for research. Clinical research allows me to identify real world problems faced by patients and clinicians, in this case, is mesh helpful or harmful in breast reconstruction, and design high quality research trials to provide answers to these questions. In doing so, I can place patient concerns and viewpoints at the heart of the research I conduct and really take the time to listen to patients. Restore-B is a patient centred and patient driven project, with patient public collaborators on the study to help guide the trial.

What would you say to people about considering whether to take part in research?

I would say taking part in research may not just benefit you, for example with increased surveillance and additional research staff supporting your patient journey, but the data from your participation in the study will be a gift to patients in the future as it will help to inform their decisions and treatments to ensure every patient gets the very best treatment and health outcome.