{"entity":{"id":"mroc","kind":"trial","name":"Mastectomy Reconstruction Outcomes Consortium (MROC)","aka":["MROC study"],"tldr":"The study that lets a woman compare the two kinds of reconstruction honestly. Building a breast from her own tissue gives her a result she is happier with two years later; it also roughly doubles the chance of a complication and of needing another operation to fix one.","summary":"MROC recruited 2,343 women having first-time reconstruction after mastectomy from eleven North American centres and 57 plastic surgeons between February 2012 and July 2015, and followed them for two years with both complication data and the BREAST-Q, a validated patient-reported outcome instrument. 1,525 (65.1 percent) had expander-implant reconstruction, 112 (4.8 percent) direct-to-implant, 390 (16.6 percent) deep inferior epigastric perforator flaps, and the rest other flaps.\n\nOn satisfaction, 1,217 women (60.5 percent) answered at two years. After adjustment for baseline characteristics, autologous reconstruction beat implant reconstruction on satisfaction with breasts (difference 7.94 points, 95 percent confidence interval 5.68 to 10.20, p<0.001), psychosocial wellbeing (3.27, 1.25 to 5.29, p=0.002) and sexual wellbeing (5.53, 2.95 to 8.11, p<0.001).\n\nOn complications the direction reverses. Complications occurred in 771 women (32.9 percent), reoperative complications in 453 (19.3 percent) and wound infections in 230 (9.8 percent). Against expander-implant reconstruction, every autologous technique carried higher odds of any complication: deep inferior epigastric perforator flap 1.97 (1.41 to 2.76, p<0.001), free transverse rectus abdominis myocutaneous flap 2.05 (1.24 to 3.40), the pedicled version 1.91 (1.10 to 3.31), latissimus dorsi 1.87 (1.03 to 3.40) and superficial inferior epigastric artery flap 4.71 (2.32 to 9.54). All the flap procedures except latissimus dorsi also carried higher odds of a reoperative complication.\n\nOne number runs the other way and matters for a woman choosing. Failure of the reconstruction was commonest with implants: 7.1 percent for the expander-implant and direct-to-implant techniques, against 1.3 percent for deep inferior epigastric perforator flaps, 2.1 percent for free transverse rectus abdominis myocutaneous flaps and none for superficial inferior epigastric artery flaps (p<0.001). The trade is a higher chance of something going wrong against a lower chance of the whole reconstruction being lost.","status":"completed","asOf":"2026-09-25","links":[{"label":"MROC long-term patient-reported outcomes (JAMA Surgery 2018)","url":"https://doi.org/10.1001/jamasurg.2018.1677"},{"label":"MROC two-year complication rates (JAMA Surgery 2018)","url":"https://doi.org/10.1001/jamasurg.2018.1687"}],"tags":[],"related":[],"cancers":["breast-cancer","breast-hr-positive","breast-her2-positive","tnbc"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["breast-reconstruction","mastectomy","body-image-after-breast-surgery"],"trials":["ibra-study","pre-bra"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"phase":"observational","setting":"First-time breast reconstruction after mastectomy at eleven centres: implant techniques (direct-to-implant, expander-implant) against autologous techniques (latissimus dorsi, pedicled and free transverse rectus abdominis myocutaneous, deep inferior epigastric perforator and superficial inferior epigastric artery flaps), with two-year complications and BREAST-Q patient-reported outcomes","sponsor":"University of Michigan, across eleven North American centres","result":"At two years, autologous reconstruction gave higher satisfaction with breasts (7.94 points on the BREAST-Q), psychosocial and sexual wellbeing than implants, but roughly double the odds of a complication; reconstruction failed in 7.1 percent of implant cases against 1.3 percent of deep inferior epigastric perforator flaps.","yearReported":2018,"enrolled":2343,"enrolledBasis":"registry","outcomes":[{"endpoint":"Satisfaction with breasts at 2 years, adjusted difference on the BREAST-Q","primary":true,"unit":"points","arms":[{"name":"Autologous reconstruction against implant reconstruction","value":7.94,"note":"95 percent confidence interval 5.68 to 10.20, p<0.001"}],"source":"https://doi.org/10.1001/jamasurg.2018.1677"},{"endpoint":"Any complication within 2 years, deep inferior epigastric perforator flap against expander-implant","unit":"odds ratio","arms":[{"name":"Deep inferior epigastric perforator flap","n":390,"value":1.97,"note":"95 percent confidence interval 1.41 to 2.76, p<0.001"}],"source":"https://doi.org/10.1001/jamasurg.2018.1687"},{"endpoint":"Reconstruction failure within 2 years","unit":"%","arms":[{"name":"Expander-implant and direct-to-implant","value":7.1},{"name":"Deep inferior epigastric perforator flap","n":390,"value":1.3},{"name":"Free transverse rectus abdominis myocutaneous flap","n":95,"value":2.1}],"p":"<0.001","source":"https://doi.org/10.1001/jamasurg.2018.1687"}]},"route":"/trials/mroc/","neighbours":{"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"term":[{"id":"body-image-after-breast-surgery","kind":"term","name":"Body image after breast surgery and reconstruction","route":"/terms/body-image-after-breast-surgery/"},{"id":"breast-reconstruction","kind":"term","name":"Breast reconstruction","route":"/terms/breast-reconstruction/"},{"id":"mastectomy","kind":"term","name":"Mastectomy","route":"/terms/mastectomy/"}],"trial":[{"id":"ibra-study","kind":"trial","name":"iBRA (implant Breast Reconstruction evAluation)","route":"/trials/ibra-study/"},{"id":"pre-bra","kind":"trial","name":"Pre-BRA (pre-pectoral breast reconstruction evaluation)","route":"/trials/pre-bra/"}]}}