{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:13:08Z","timestamp":1790691188536,"version":"4.1.0"},"reference-count":32,"publisher":"BMJ","issue":"9","funder":[{"name":"Basel Cancer League","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Swiss Cancer League","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Swiss National Foundation","award":["33IC30_185613\/1"],"award-info":[{"award-number":["33IC30_185613\/1"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                                                  <jats:title>Introduction<\/jats:title>\n                                                  <jats:p>The emphasis on aesthetic outcomes and\n                                                  quality of life (QoL) has motivated surgeons to\n                                                  develop skin-sparing or nipple-sparing mastectomy\n                                                  (SSM\/ NSM) for breast cancer treatment or\n                                                  prevention. During the same operation, a so-called\n                                                  immediate breast reconstruction is performed. The\n                                                  breast can be reconstructed by positioning of a\n                                                  breast implant above (prepectoral) or below\n                                                  (subpectoral) the pectoralis major muscle or by\n                                                  using the patients\u2019 own tissue (autologous\n                                                  reconstruction). The optimal positioning of the\n                                                  implant prepectoral or subpectoral is currently\n                                                  not clear. Subpectoral implant-based breast\n                                                  reconstruction (IBBR) is still standard care in\n                                                  many countries, but prepectoral IBBR is\n                                                  increasingly performed. This heterogeneity in\n                                                  breast reconstruction practice is calling for\n                                                  randomised clinical trials (RCTs) to guide\n                                                  treatment decisions.<\/jats:p>\n                                                  <\/jats:sec>\n                                                  <jats:sec>\n                                                  <jats:title>Methods and analysis<\/jats:title>\n                                                  <jats:p>International, pragmatic, multicentre,\n                                                  randomised, superiority trial. The primary\n                                                  objective of this trial is to test whether\n                                                  prepectoral IBBR provides better QoL with respect\n                                                  to long-term (24 months) physical well-being\n                                                  (chest) compared with subpectoral IBBR for\n                                                  patients undergoing SSM or NSM for prevention or\n                                                  treatment of breast cancer. Secondary objectives\n                                                  will compare prepectoral versus subpectoral IBBR\n                                                  in terms of safety, QoL and patient satisfaction,\n                                                  aesthetic outcomes and burden on patients. Total\n                                                  number of patients to be included: 372 (186 per\n                                                  arm).<\/jats:p>\n                                                  <\/jats:sec>\n                                                  <jats:sec>\n                                                  <jats:title>Ethics and dissemination<\/jats:title>\n                                                  <jats:p>This study will be conducted in compliance\n                                                  with the Declaration of Helsinki. Ethical approval\n                                                  has been obtained for the lead investigator\u2019s site\n                                                  by the Ethics Committee \u2018Ethikkommission Nordwest-\n                                                  und Zentralschweiz\u2018 (2020\u201300256, 26 March 2020).\n                                                  The results of this study will be published in a\n                                                  peer-reviewed medical journal, independent of the\n                                                  results, following the Consolidated Standards of\n                                                  Reporting Trials standards for RCTs and good\n                                                  publication practice. Metadata describing the\n                                                  type, size and content of the datasets will be\n                                                  shared along with the study protocol and case\n                                                  report forms on public repositories adhering to\n                                                  the FAIR (Findability, Accessibility,\n                                                  Interoperability, and Reuse) principles.<\/jats:p>\n                                                  <\/jats:sec>\n                                                  <jats:sec>\n                                                  <jats:title>Trial registration number<\/jats:title>\n                                                  <jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial pre-results\" xlink:href=\"NCT04293146\">NCT04293146<\/jats:ext-link>.<\/jats:p>\n                                                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-045239","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T09:46:51Z","timestamp":1644832011000},"page":"e045239","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Prepectoral versus subpectoral\n                                                  implant-based breast reconstruction after\n                                                  skin-sparing mastectomy or nipple-sparing\n                                                  mastectomy (OPBC-02\/ PREPEC): a pragmatic,\n                                                  multicentre, randomised, superiority trial"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct04293146","registry":"10.18810\/clinical-trials-gov","type":"preResults"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4057-1951","authenticated-orcid":false,"given":"Elisabeth A","family":"Kappos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith 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