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Toward International Harmonization of Breast Implant Registries: International Collaboration of Breast Registry
Pauline E R Spronk1, Husna Begum1, Swarna Vishwanath1
1From the Department of Surgery, Leiden University Medical Center; the Department of Research, Dutch Institute for Clinical Auditing; the Department of Epidemiology and Preventive Medicine, Monash University; the Medicines and Healthcare Products Regulatory Agency; Westmead Breast Cancer Institute, University of Sydney; Breast Surgeons of Australia and New Zealand; the Division of Plastic, Aesthetic, and Reconstructive Surgery, Department of Surgery, Medical University of Graz; the Division of Epidemiology, Center for Devices and Radiological Health, U.S. Food and Drug Administration; the Australian Centre for Cosmetic Surgery; the Australasian College of Cosmetic Surgery; the Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam; the Department of Plastic and Reconstructive Surgery, Nottingham University Hospitals NHS Trust; the Department of Plastic and Reconstructive Surgery, Brigham Health; the Department for Molecular Medicine and Surgery, Karolinska Institute; the Department of Plastic and Reconstructive Surgery, Hand Surgery, Helios-Clinic Emil-von-Behring; the Department of Plastic Surgery, St. George's Hospital; the Australian Society of Plastic Surgeons; and the Department of Plastic, Reconstructive, and Hand Surgery, Medisch Spectrum Twente.
Background:
The Poly Implant Prothèse incident and breast implant-associated anaplastic large cell lymphoma have pointed to the need for uniform registries for breast implants as key features to monitoring the outcomes of breast implant surgeries internationally. The purpose of this study was to identify and harmonize common data elements collected by breast implant registries across the International Collaboration of Breast Registry Activities (ICOBRA) global consortium.
Methods:
The authors convened an international group of surgeons, consumers, nurses, registry experts, and regulators to review the data points. A modified Delphi approach was applied, to rate the importance of each point on a six-point Likert scale.
Results:
Data points from six national breast implant registries were divided into categories: clinical, implant-related, patient-reported findings; operation details and implanting technique details; patient characteristics; unique device identifiers; unique patient identifiers; and clinical demographics. A total of 52 data points collected by over 33 percent of national registries were identified. After five rounds, 34 data points formed the final set with agreed definitions. The group recognized the critical importance of additional elements that are currently not uniformly collected (e.g., patient-reported outcomes and long-term data) and set out the process for the dynamic global set updates driven by evidence gaps.
Conclusions:
The authors defined internationally agreed on common data elements and definitions used in breast implant registries. This collaboration will allow data sets to be combined, enabling an effective global early warning system of implant-related problems and further work on data sets.
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