Post Mastectomy Breast Reconstruction PSP Top 10

1. 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?
2. How can timely access to breast reconstruction services be improved across Canada for immediate and delayed breast reconstruction?
3. What are the rates of breast cancer re-occurrence and what patients are at a higher risk of breast cancer after breast reconstruction?
4. How does breast reconstruction surgery impact future surveillance?
5. How does radiation therapy affect breast reconstruction including the optimal wait time?
6. What are the satisfaction rates associated with each type of breast reconstruction?
7. Are there any rehabilitation treatments or exercises during the waiting period after mastectomy that are proven to help improve outcomes after reconstruction?
8. How can a patient prepare prior to surgery (for example: rehabilitation treatments and exercises) to improve outcomes after breast reconstruction?
9. What are the pros and cons of the different types (materials) of implants available for breast reconstruction in Canada?
10. What is the evidence and safety behind fat grafting for breast reconstruction?

The following questions were also discussed and put in order of priority at the workshop: 

11. What are the short and long term safety concerns of implants?
12. What are the factors associated with success and failure of breast reconstruction?
13. What should be the ideal wait time between mastectomy and delayed breast reconstruction in a patient who has had radiation versus a patient who has not had radiation?
14. What is the evidence behind implants and the development of anaplastic large cell lymphoma (ALCL) and breast implant illness?
15. What are the pros and cons of nipple sparing surgery versus non- nipple-sparing surgery and nipple reconstruction at a later stage?
16. What proportion of patients regret having breast reconstruction?
17. What are the failure rates associated with each type of breast reconstruction?
18. What are the possible complications as well as side effects of post mastectomy breast reconstruction?
19. What are the rates of re-operation after different breast reconstruction methods?
20. How can complications be prevented after post mastectomy breast reconstruction?
21. In a patient with breast cancer, what are the pros and cons of having mastectomy with immediate breast reconstruction?
22. What is the evidence behind new breast reconstruction techniques (for example: dermal matrix)?
23. How many future surgeries should patients expect with each type of surgery?
24. What is the lifetime of a breast implant?
25. What are the different ways to improve sensation in the reconstructed breast?

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For full details of all of the questions identified by this PSP, please see the document below.