Priority 1 from the Post Mastectomy Breast Reconstruction PSP

UNCERTAINTY: How to determine the most suitable breast reconstruction surgery for each individual patient taking into consideration pros and cons of each procedure and the patient’s unique medical history and personal values?  (JLA PSP Priority 1)
Overall ranking 1
JLA question ID 0109/1
Explanatory note Research has shown that patient satisfaction with breast reconstruction is highly correlated with preoperative patient expectations, the information that patients receive prior to surgery, the quality of the shared decision-making process between the patient and the surgeon. In essence, the level of satisfaction with surgical outcomes can depend a great deal on how thoroughly patients are individually assessed, and on whether their personal preferences are taken into account by the surgeon. For each patient, there may be one or more breast reconstruction procedures that may ultimately produce the most satisfaction out of the different surgical options. The goal of research in this area would be to develop a method for determining the most suitable breast reconstruction method for each individual patient that may ensure the greatest long-term patient satisfaction.  
Evidence

Breast reconstruction following prophylactic or
therapeutic mastectomy for breast cancer. Alberta Health Services - Cancer Care

Early and locally advanced breast cancer: diagnosis and management. Evidence-based recommendations on diagnosing and managing early and locally advanced breast cancer.

Breast cancer reconstruction surgery (immediate and delayed) across Ontario: patient indications and appropriate surgical options. Cancer Care Ontario's Program in Evidence-based Care 
Health Research Classification System category  Cancer
Extra information provided by this PSP
Original uncertainty examples Important to take time to review different techniques and outcomes of each. ~ Knowing exactly what options are a possibility in my particular case, so that I could prepare necessary questions ~ What different types of reconstruction are done and what are the pros and cons of all. ~ I do not understand the pros and cons between implants and flap reconstruction and what would make you a good candidate for each.
Submitted by  156 x Patients and Care-givers,  67 x Clinicians
PSP information
PSP unique ID 0109
PSP name Post Mastectomy Breast Reconstruction
Total number of uncertainties identified by this PSP.

86  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 2 July 2019