Post Mastectomy Breast Reconstruction
About this PSP
Breast cancer is estimated to affect 1 in 9 Canadian women during their lifetime. Treatment can involve surgical removal of one or both breasts (mastectomy). Breast reconstruction aims to surgically restore the shape of the breast. This surgery does not interfere with the treatment of breast cancer or monitoring for a return of breast cancer.
While breast reconstruction is an optional surgery it can have important emotional and practical benefits. There are many surgical options available to patients based on a variety of physical and personal factors.
The PSP was funded by the Canadian Institutes of Health Research and was part of the Canadian National Research Consortium on breast reconstruction.
The Post Mastectomy Breast Reconstruction PSP Top 10 was published in September 2021.
Key documents
Post Mastectomy Breast Reconstruction PSP (Canada) Protocol
Post Mastectomy Breast Reconstruction PSP (Canada) Question Verification Form
Post Mastectomy Breast Reconstruction PSP (Canada) Engagement Summary
Top 10 Priorities
- 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?
- How can timely access to breast reconstruction services be improved across Canada for immediate and delayed breast reconstruction?
- What are the rates of breast cancer re-occurrence and what patients are at a higher risk of breast cancer after breast reconstruction?
- How does breast reconstruction surgery impact future surveillance?
- How does radiation therapy affect breast reconstruction including the optimal wait time?
- What are the satisfaction rates associated with each type of breast reconstruction?
- Are there any rehabilitation treatments or exercises during the waiting period after mastectomy that are proven to help improve outcomes after reconstruction?
- How can a patient prepare prior to surgery (for example: rehabilitation treatments and exercises) to improve outcomes after breast reconstruction?
- What are the pros and cons of the different types (materials) of implants available for breast reconstruction in Canada?
- 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:
- What are the short and long term safety concerns of implants?
- What are the factors associated with success and failure of breast reconstruction?
- 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?
- What is the evidence behind implants and the development of anaplastic large cell lymphoma (ALCL) and breast implant illness?
- What are the pros and cons of nipple sparing surgery versus non- nipple-sparing surgery and nipple reconstruction at a later stage?
- What proportion of patients regret having breast reconstruction?
- What are the failure rates associated with each type of breast reconstruction?
- What are the possible complications as well as side effects of post mastectomy breast reconstruction?
- What are the rates of re-operation after different breast reconstruction methods?
- How can complications be prevented after post mastectomy breast reconstruction?
- In a patient with breast cancer, what are the pros and cons of having mastectomy with immediate breast reconstruction?
- What is the evidence behind new breast reconstruction techniques (for example: dermal matrix)?
- How many future surgeries should patients expect with each type of surgery?
- What is the lifetime of a breast implant?
- What are the different ways to improve sensation in the reconstructed breast?
Document downloads
For full details of all of the questions identified by this PSP, please see the document below.