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BACKGROUND: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy.

METHODS: Consecutive women undergoing mastectomy ± IBR for breast cancer July-December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored.

RESULTS: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays.

CONCLUSIONS: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients.

The purpose of this study is to extend the literature on grounded theory development to incorporate considerations for team-based, interdisciplinary longitudinal research projects in the domain of organizational studies. Every element of the research process is affected if the research questions call for team-based data collection and interpretation over a lengthy period of time. It is unusual for a team of scholars from different disciplines to work together, not because the need doesn't exist, but because the mechanisms for doing so are not well established. We draw from the writings of scholars in the fields of research methodology, team and work-group design, and project management to inform our thinking on the subject. The work presented here is based on the authors' experiences during 1995–1999 as members of the Radical Innovation Research Program (RIRP). The RIRP is an ongoing multidisciplinary study of the development and management of radical innovations in established firms. Here, we do not describe the findings or insights associated with the content of the study, radical innovation, which is surely a complex managerial phenomenon. Rather, we focus on the processes used to conduct the research that were affected by the need for a multidisciplinary research team. A framework is presented for thinking about managing such a project. Challenges that we encountered within this framework are identified. Mechanisms we used (or, in some cases, wish we had used in retrospect) for confronting those challenges are also described. Throughout, we compare our study objectives and resultant methodological design choices with those of other multidisciplinary research teams that are by now well known in the organizational management literature. Our objective is to help researchers who are considering launching interdisciplinary, longitudinal studies of organizational processes as they plan and manage those pursuits.