A mother from West-Oxfordshire has been given a 'once-in-a lifetime' sternum transplant in a UK-first surgery.

Nathalie Brett, 34, was diagnosed with metastatic stage four breast cancer when she was 24. 

After giving birth to a healthy baby girl in 2020, Nathalie was referred to Thoracic Surgery Consultant Francesco Di Chiara because the cancer wasn’t progressing as expected.

Apart from her sternum, Nathalie had no other site with evidence of disease which opened the door to some surgical options.

Oxford Mail: Nathalie Brett and the team that performed the UK-first surgery. Credit: OMI/OUHNathalie Brett and the team that performed the UK-first surgery. Credit: OMI/OUH

Nathalie’s entire sternum, as well as part of her collarbone, was removed and replaced with a donor's bone during the UK-first operation in June 2021 at the John Radcliffe Hospital in Oxford.

Nathalie said: “I was baffled that they were able to even do something like this and I was excited at the prospect of what it could bring. I was offered a once-in-a-lifetime surgery and, although it was a hard decision to make, I had to take it – for my daughter and for my family. I couldn’t say no.

“I had complete faith and trust in Mr Di Chiara and his team which made the decision to go ahead with the surgery a much easier one.”

The surgery was performed by Francesco Di Chiara, Consultant Orthopaedic Oncology Surgeon and Lead Clinician for Sarcoma Tom Cosker, from the Oxford University Hospitals NHS Foundation Trust.

Oxfordshire mum receives 'once-in-a lifetime' sternum transplant

The 'once-in-a-lifetime' operation was supported by the NHS Blood and Transplant Tissue Donation team.

Once the donor's bone was integrated with Nathalie, her bone marrow cells inhabited the implant and became 'alive' again.

Mother-of-one Nathalie is now virtually pain-free following her surgery and, despite advanced cancer, has "now been given a better chance of living longer," the NHS team has said.

There is also virtually no risk of rejection or chronic infection," the NHS Blood and Transplant Tissue team added.

Francesco Di Chiara, Thoracic Surgery Consultant at the Trust, said: “When I was offered the opportunity to meet with Nathalie, I found it astounding that she had been diagnosed with advanced-stage cancer a decade ago and on top of that that she managed to deliver a healthy baby less than a year before.

Di Chiara added: “It is amazing how the paradigm of treatment has changed for patients with cancer, with a greatly extended life expectancy even in the face of a diagnosis of advanced-stage cancer, the surgical community more and more has to think of new solutions that take into greater consideration the quality of life and longevity of patients."

                                                                                                              

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It is thought that this is the first time that this operation has been done in the UK after another similar procedure was carried out in Italy.

Eight months on, Nathalie is feeling well and is looking after her young daughter, Elsa, without support.

Nathalie said: “We’re still in the early days but it has certainly given us a lot of hope. For the first time in over a decade I have no active cancer in my body and that is something we never thought would happen.

She added: I’m very grateful that someone out there chose to be a donor in the event of death, and I wish that person could know what a difference their decision made – thank you from the bottom of my heart. For the first time in a very long time, I can see a future in which I might get to grow old and most importantly get to see my daughter grow up.”

Kyle Bennett, Assistant Director for Eye and Tissue Services at NHS Blood and Transplant, said: “We are so pleased that Nathalie was able to get this life-changing transplant thanks to the generosity of a donor and their family.

Mr Bennett added: “It was a privilege for us to be able to work with the team at Oxford University Hospitals to enable this incredible operation to go ahead. Transplants, and firsts of this kind, just wouldn’t be possible without the generous support from families who say yes to donation, at what is often some of the hardest and most difficult times of their lives.”