Breast reconstruction using polyurethane-coated implants reduces scarring and the need for further surgery

European Organisation for Research and Treatment of Cancer

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Barcelona, Spain: Women who are treated with mastectomy for breast cancer often choose to have surgery to reconstruct the breast using an implant. But hard, painful scar tissue can form around the implant, especially when women have radiotherapy as part of their treatment.

 

New research, presented at the 15th European Breast Cancer Conference (EBCC15) in Barcelona today (Wednesday), shows that the risk of this scarring and the need for further corrective surgery could be reduced if women are given a polyurethane-coated breast implant. These implants are made of silicon, but they have a spongy outer layer, made of polyurethane.

 

The research was presented by Dr Kerstin Wimmer, a surgeon at the Medical University of Vienna, Austria, and a researcher at the Karolinska Institutet in Stockholm, Sweden, and carried out by a team including Professor Walter Weber, University Hospital Basel, Switzerland, Professor Florian Fitzal, Hanusch Hospital, Vienna, Austria, and Dr Rama Kiblawi, University Hospital Basel, Switzerland.

 

Dr Wimmer said: “It is well known that radiotherapy after mastectomy increases the risk of complications in women who have breast reconstruction with an implant. One of the most important complications is capsular contracture, where scar tissue forms around the implant, leading to a hard, uncomfortable and sometimes painful breast, but also to visible changes in breast shape.
 

“This situation is relatively common, as many women with high-risk breast cancer need radiotherapy after mastectomy. However, there is limited real-world evidence on whether the type of implant can influence the risk of scarring.”

 

The research included 1455 women treated for breast cancer between 2016 and 2024 at 26 sites in 15 countries [1]. The average age of the women was 47. All were treated with mastectomy (removal of the breast), followed by reconstruction with a breast implant, with 475 of the women receiving a polyurethane-coated implant and 980 receiving an implant without polyurethane coating. All the women then received radiotherapy.

 

Following treatment, researchers continued to track the women’s health for two-and-half to three years. They found that women who received a polyurethane-coated implant were less likely to develop any signs of capsular contracture (scar tissue) (32.8% compared to 47.5% of women who received a non-polyurethane-coated implant) and less likely need a second operation to remove scar tissue (9.3% compared to 25.7% of women who received a non-polyurethane-coated implant). The risks of a major infection in the breast or the implant having to be urgently removed were also lower.

 

The study was retrospective, meaning researchers looked back at how the two types of implants influenced the outcomes of surgery, so treatments were not randomly assigned.

 

Dr Wimmer told the conference: “Our study suggests that women who received polyurethane-coated implants had far fewer problems after radiotherapy than those who received standard implants. For patients, this research suggests that the type of implant used may have a major impact on the risk of complications after radiotherapy. For clinicians, it provides important evidence to help guide reconstructive planning for patients who are likely to need radiotherapy.

 

“The choice of implant can depend on several factors, including the surgeon’s experience and preference, availability of implants, cost, local regulations, and the individual patient’s situation. Polyurethane-coated implants have been used for many years and are generally considered safe. Like all medical devices, they can have complications, which is why careful follow-up and long-term monitoring are important.”

 

This research has been recognised with the EBCC15 Multidisciplinary Team Award and was carried out within the framework of the Oncoplastic Breast Consortium, an international research network that brings together breast surgeons and researchers from around the world.

 

The Chair of EBCC15, Professor Isabel Rubio, Head of Breast Surgical Oncology at the Clínica Universidad de Navarra in Madrid, Spain, was not involved in this research. She said: “This study highlights an important step forward in improving long-term outcomes for women undergoing breast reconstruction after mastectomy. While reconstructive surgery has advanced considerably, capsular contracture remains one of the most challenging complications, particularly for patients who also require radiotherapy. The findings suggest that polyurethane-coated implants may reduce the risk of capsular contracture and the need for additional corrective surgery. If confirmed in further prospective studies, this approach could help improve patient comfort, aesthetic outcomes and overall quality of life.

 

“As we continue to move towards more personalised breast cancer care, evidence like this is valuable in guiding implant selection and treatment planning. The ultimate goal is not only to treat the cancer effectively, but also to minimise long-term side effects and enhance recovery for patients.”

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Method of Research

Observational study

Subject of Research

People

COI Statement

Florian Fitzal received travel grants from Bondimed and Polytech

 

New research suggests FDA should consider redesign of proposed nutrition labels

Study looks at better ways to inform consumers about saturated fat, sodium, added sugar

University of California - Davis

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image: 

A federal proposal would require a small “nutrition info” box on the front of most packaged foods describing if saturated fat, sodium and added sugars content was “low,” “medium,” or “high.” A new study led by UC Davis researchers suggests alternative designs to proposed FDA labels, such as the soda bottles above. Soda bottles pictured above, no label (control), FDA proposed label ("Nutrition Info %DV"), researchers’ proposed, modified version of the FDA proposed label ("Nutrition Info Red"), FDA’s design of a “high in" label that they tested in their experimental study, and researchers’ recommended "high in” label design. (Aijia Wang/UC Davis)

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Credit: (Aijia Wang/UC Davis)

By Tiffany Dobbyn, UC Davis

Packaged foods offer convenience for families and individuals, but they can be a major source of saturated fat, sodium and added sugars, which when consumed in excess contribute to chronic disease. To help people build healthier diets, the U.S. Food and Drug Administration proposed a new front-of-package nutrition label in January 2025 that would inform consumers about the presence of these nutrients.

While the FDA works to finalize the label, a research team led by the University of California, Davis, suggested a design that highlights products that are high in added sugar, sodium or saturated fat. They suggest in a new study an easy-to-understand label that make the healthfulness of foods more apparent.

Their study was published March 24 in the journal, The Lancet Public Health. 

The FDA’s effort to provide shoppers with an at-a-glance guide is an important step, said Jennifer Falbe, UC Davis associate professor of nutrition and human development and corresponding author of the study.

The federal proposal would require a small “nutrition info” box on the front of most packaged food. Saturated fat, sodium and added sugars would each be listed with a rating of “low,” “medium” or “high.”  This would be based on the % Daily Value, as defined by the FDA, which for these nutrients are a daily limit, in one serving. The labels would also list the numeric % Daily Value. 

However, to make nutrient content easier to understand, researchers suggest that front-of-package labels should only flag products that are high in added sugar, sodium or saturated fat with labels that says “high in” a specific nutrient. 

For example, a candy product might have one simple “high in added sugars” label. A pot pie might have “high in sodium” and “high in saturated fat” labels, researchers said.

The FDA label for the same candy and pot pie would list all those nutrients and the low, medium or high levels with the exact % Daily Value of each.

Putting labels to the test

Researchers conducted an online randomized controlled trial with more than 13,000 adults across the United States to compare the FDA’s proposed black-and-white nutrition info box to alternative designs to assess the effects of the labels on consumer understanding and behavior.

Falbe said “high in” label designs outperformed the FDA’s proposed label in helping participants quickly identify healthier choices. Using multiple “high in” labels, such as “high in added sugar,” “high in sodium,” or “high in saturated fat” also surpassed the FDA’s label in helping participants choose healthier foods for themselves in virtual shopping settings.

Also, compared to “high in” labels, the FDA’s proposed “nutrition info” labels caused participants to misperceive items such as processed meat and candy as healthier. “That’s probably because the FDA label listed two ‘lows’ and one ‘high’ for these products,” said Falbe. “The two ‘low’s’ may have created a false health halo, another reason the FDA should go with a ‘high in’ label.”

“This label will be seen every day by millions of Americans for decades, so the FDA should pick the best label,” Falbe said.

The new proposed label would be on display on the front of packages in addition to the nutrition facts panel already seen on the back or side of most food and beverage products. 

“A lot of people overconsume added sugars, sodium and saturated fat, so to be able to quickly see that ‘high-in’ label makes it very easy to say, ‘maybe I should avoid that today,’” said Brittany Lemmon, a Ph.D. candidate in epidemiology and lead author of the study.

Other co-authors of the study are Alejandra Marquez, Lisa Soederberg Miller, Lauren Au, Susan Brown and Aijia Wang all of UC Davis, and researchers from the Stanford University School of Medicine and the University of Illinois Chicago School of Public Health.

This project was supported by grants from Bloomberg Philanthropies’ Food Policy Program and from Healthy Eating Research, a national program of the Robert Wood Johnson Foundation. A co-author was funded by the National Institutes of Health.

Media Resources

Link to photos of proposed labels and captions and PDF of study.

 

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Journal

The Lancet Public Health

Method of Research

Randomized controlled/clinical trial

Subject of Research

People

Article Publication Date

24-Mar-2026

Parenting programs can improve wellbeing for families from diverse backgrounds

University College London

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Evidence-based parenting programmes delivered through community organisations can support family wellbeing and should be considered as part of wider strategies to reduce health inequalities, a landmark UCL study has found.

In a new paper published in The Lancet Public Health, the researchers assessed the effectiveness and value for money of the Race Equality Foundation-designed Strengthening Families, Strengthening Communities (SFSC) programme, which has been run for parents and children aged up to 18 in the UK for the last two decades.

Previous evaluations of parenting programmes have produced mixed results and have sometimes failed to distinguish between the specific benefits of the programme and those derived from greater interaction with health and social care professionals.

This five-year National Institute for Health and Care Research-funded study aimed to address that by using a randomised control trial to objectively assess the health benefits of the SFSC programme.

The study involved 674 parents and caregivers of children aged three to 18 living in disadvantaged and ethnically diverse communities across England. Parents attended weekly group sessions, led by a trained facilitator, focused on topics such as emotional social skills, discipline and parent-child relationships.

Parents who participated in the programme reported higher levels of mental wellbeing than those in the waiting list control group both immediately after the 13-week programme and at a six-month follow-up.

The study also found improvements in several secondary outcomes, including children’s socioemotional wellbeing, parenting practices, family conflict and relationship quality. The benefits of the programme were consistent across different groups, suggesting the programme worked well for families across a wide range of backgrounds.

The economic analysis found no major cost savings from the programme, although there were some indications that reduced use of services helped to offset its cost. Overall, the authors conclude that the relatively low cost of the programme, alongside the positive outcomes seen, suggests it may still represent reasonable value for money.

First author Professor Richard Watt (UCL Institute of Epidemiology and Health Care) said: “People who have done the programme are almost evangelical about the way it has changed their lives for the better.

“We know that parental mental wellbeing is a critical foundation for healthy family relationships and children’s development and that even modest improvements can make a meaningful difference to how parents cope with everyday pressures and support their children.

“What our study has shown is that community-based parenting programmes such as SFSC can successfully engage diverse families and improve wellbeing.”

The researchers said that in terms of the primary outcome, better mental wellbeing, although the effect size – the measure of their findings’ significance in practice, as opposed to in statistical terms – was small, their findings were statistically significant.

Participants who took part in the programme reported better mental wellbeing both immediately after the programme and at the six-month follow-up, whereas a deterioration in the mental health of those in the control group was observed.

Other outcomes which improved – both immediately after the programme and at the six-month follow-up stage – included higher positive and fewer negative parenting practices and fewer conflicts in child-parent relationships. Improved closeness in child-parent relationships compared with those in the control group was reported at the six-month follow-up.

Co-author Dr Anita Mehay (City St Georges, University of London) said: “Small improvements can be meaningful; for instance, a parent shifting from rarely to some of the time in feeling confident or close to others can make a real difference in their ability to cope and manage daily demands for their families.

“Evidence also shows that even small individual benefits can lead to substantial benefits across an entire population when introduced at scale and may contribute to reducing health inequalities.”

A couple who took part in the programme, Salma and Tamym, said: “Taking part in the programme really changed how we communicate and support each other as parents and as a couple.

“It helped us understand our children and each other better and feel more confident in how we handle challenges day to day.

“Also just being that support for one another. Connecting with other families and reflecting on our different cultures and values was a big part of that. It’s made a real difference to our family life.”

Race Equality Foundation chief executive Jabeer Butt OBE said: “We are delighted that this study confirms what we have seen over many years of delivering Strengthening Families, Strengthening Communities: that inclusive, community-led support can have a profound impact on parents and children.

“We have consistently seen improvements in parental confidence, stronger relationships within families and improvements in children’s wellbeing.

“Crucially, this evidence shows the programme works for Black, Asian and minoritised ethnic families who are often under-served by mainstream provision, demonstrating that universal interventions can also be equitable.

“The priority now is to scale up delivery so that more families, particularly those facing the greatest disadvantage, can benefit as part of a wider strategy to improve child health and advance race equity.”

The SFSC programme is delivered through a structured 13-week curriculum, consisting of weekly three-hour group sessions with 10 to 12 parents or carers.

The curriculum is organised into five thematic components: ethnic, cultural, spiritual, and family identity; rites of passage; enhancing relationships; process of discipline and behaviour management; and community involvement.

Within these, parents engage with topics such as understanding children’s developmental stages, building positive discipline strategies, strengthening parent-child relationships, promoting emotional and social skills, and supporting active community participation.

Each programme is delivered by two trained facilitators who have completed the Race Equality Foundation’s five-day training. The overall programme is commissioned by local authority agencies, healthcare trusts and other statutory agencies across England and Wales.

Notes to Editors

For more information or to speak to the researchers involved, please contact Nick Hodgson, UCL Media Relations. T: +44 (0)7769 240209, E: nick.hodgson@ucl.ac.uk 

Richard G Watt, Annemarie Lodder, Leandra Box, Andrew Brand, Jabeer Butt, Mike Crawford, Anja Heilmann, Zoe Hoare, Saffron Karlsen, Yvonne Kelly, Karlet Manning, Efthalia Massou, Stephen Morris, Hana Pavlickova, Paul Ramchandani, Grzegorz Suldecki, Timothy Weaver, Anita Mehay, ‘Effectiveness and cost-effectiveness of a parenting programme to improve family wellbeing in England (TOGETHER): a multicentre, single-blind, randomised controlled trial’, will be published in The Lancet Public Health on Tuesday March 24th at 23:30 UK time / 18:30 US Eastern time and is strictly embargoed until then.

The post-embargo weblink will be https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(26)00046-0/fulltext 

For the trial, six socially and ethnically diverse urban regional areas in England were selected, encompassing 34 commissioning boundaries (‘research sites’) where the SFSC parenting programme was already in place.

Each site designated specific planned programmes to the trial, with agreed recruitment targets. Parents were recruited through a combination of existing service waitlists, referrals from agencies such as social work, family support, or criminal justice services and self-referrals. Self-referrals were also encouraged.

About University College London (UCL)

UCL is a global top 10 university, set up in London 200 years ago to offer education for all. Today, we gather 60,000 staff and students, from over 150 countries, to create a unique city within a city – a research and innovation powerhouse that leads the world in subjects spanning the arts, sciences, technology and the humanities. We’ve nurtured 33 Nobel Prize winners, because here, brave ideas have the scale and the support they need to succeed. We are University College London. And here, it can happen. 

UCL turns 200 in 2026. Join us for a year of bicentennial events and celebration. 

www.ucl.ac.uk

The National Institute for Health and Care Research

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. 

We do this by:

• funding high quality, timely research that benefits the NHS, public health and social care
• investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services
• partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research
• attracting, training and supporting the best researchers to tackle complex health and social care challenges
• collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system
• funding applied global health research and training to meet the needs of the poorest people in low and middle income countries

NIHR is funded by the Department of Health and Social Care. 

Our work in low and middle income countries is principally funded through UK international development funding from the UK government.

 

 

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Journal

The Lancet Public Health

DOI

10.1016/S2468-2667(26)00046-0 

Method of Research

Observational study

Subject of Research

People

Article Title

Effectiveness and cost-effectiveness of a parenting programme to improve family wellbeing in England (TOGETHER): a multicentre, single-blind, randomised controlled trial’

Article Publication Date

24-Mar-2026