Introduction

We know that having your breast(s) reconstructed is a personal decision that has a tremendous impact on how you feel about yourself and your body. Our research is focused on understanding more about the personal impacts of breast reconstruction procedures on patient satisfaction and quality of life.

We currently offer every technique of reconstruction from DIEP flaps, to thigh and buttock flaps, as well as two-stage and one-stage implant based breast reconstructions. However, what no one knows is which one of these techniques provides the best long-term cosmetic result, has the least trauma on your body, and produces the greatest satisfaction in the long run. Therefore, the ultimate goal of our research is to acquire a better understanding of the impact of each procedure on these aspects of your life. 

We have a number of breast reconstruction clinical trials comparing different procedures and questionnaire outcome studies that you may be interested in learning more about and our Clinical Research Coordinator, Kate Butler, is always available to provide more detailed information about each of these studies.

Your participation may not be of direct benefit to you but we hope that it will help us to improve patient care and benefit other women and breast cancer survivors choosing breast reconstruction surgery in the future.

 

Current Clinical Studies

1) Post Mastectomy Breast Reconstruction: A Comparative Study of the Psychological Implications of DIEP Flap and Implant Procedures 
The goal of this questionnaire outcome study is to identify and compare the psychological and medical determinants of aesthetic satisfaction, psychosocial, body image and sexual functioning in women who undergo a DIEP flap or implant reconstructive procedure after their mastectomy.

2) Acellular dermal matrix in one-stage breast reconstruction: a RCT 
The purpose of this multi-center randomized controlled trial is to evaluate the impact of implantable human cadaveric acellular dermal matrix in the setting of immediate one-stage implant breast reconstruction compared with a two-stage tissue expander/ implant procedure. This study has completed patient recruitment. We are continuing to follow up with all participating patients and look forward to sharing the final study results.
 
3) Decision Support Workshop
The purpose of this study is to assess the impact of different decision support methods on the decision-making process of women who are considering breast reconstruction. We know that patients have trouble finding reliable information about breast reconstruction surgery. The number of different surgical procedures and list of possible complications can be overwhelming, making the decision-making process a challenge. We have developed a pre-consultation educational group intervention (decision support workshop), an information booklet, this website and access to a previous breast reconstruction patient volunteer if desired, as decision support tools. This study is a randomized controlled trial, so patients who enrolled will be randomized (give a 50/50 chance) to be in one out of two study groups, who will test the different decision support methods. This study has completed patient recruitment. We are continuing to follow up with all participating patients and look forward to sharing the final study results.

4) Breast surgery Quality of Life Outcomes
It is a prospective study of breast surgery patients looking at changes in psychosocial functioning over time.  The purpose is to determine differences between short and long term patient satisfaction and quality of life outcomes.  We plan to compare impact of different surgical treatments for breast cancer including breast reconstruction following breast cancer and women at high genetic risk of breast cancer undergoing prophylactic mastectomies.


Teaching Program Residency Teaching Program

The UHN Breast Reconstruction Program provides valuable teaching to graduating residents in the Plastic and Reconstructive Residency Program at the University of Toronto. Each year, we have between 3 – 4 rotating senior or graduating residents who come to learn the principles of reconstruction following oncologic ablation including breast reconstruction, microsurgical skills, and management of complex cutaneous malignancies.

 

International Fellowship Program

At the UHN Breast Reconstruction Program, we have both the largest postgraduate breast reconstruction training program, as well as the longest history of a microsurgical training program in Canada. Each year, our program offers three international fellowship opportunities.

There is one microsurgical/Head & Neck fellowship position which is funded by the Department of Surgery at UHN. This fellowship entails one year of intensive microsurgical training with a focus on head and neck reconstruction.

There are two Breast Reconstruction fellowship positions available each year funded by Allergan Corporation. The Breast Reconstruction fellows spend six months at UHN learning free tissue transfer techniques, oncoplastic breast surgery, as well as implant and acellular dermal substitute techniques of breast reconstruction. The volume of breast reconstruction is approximately 200 microsurgical breast reconstructions, 150 implant reconstructions, and 200 secondary breast procedures per annum.

For more information on the University of Toronto Residency Training Program and Fellowship Opportunities,
please go to http://www.uoftplasticsurgery.ca/main.php?p=833&s=5

 

Teaching other Health Professionals

To maintain high level of professionalism and safety in patient care, we offer routine in-service training sessions to our operating room nurses, in-patient floor nurses, recovery room and preoperative staff, physiotherapists, and patient managers. During these sessions, pre- and postoperative patient care protocols are reviewed, and any concerns or questions from the nursing staff are addressed. The overall aim of these interactive sessions is to continuously improve the quality of care delivered to our breast reconstruction patients.

 

For additional information on any of our research studies, please contact the research team.

Kate Butler, Research Coordinator II
Phone: 416-340-4800 ext. 2343
Email: kbutler@uhnresearch.ca

Natalie Causarano, Research Coordinator I
Phone: 416-340-4800 ext. 6598
Email: natalie.causarano@uhn.ca

Linda Chan, Research Coordinator I
Phone: 416-340-4800 ext.5799
Email: linda.chan@uhn.ca

Heidi Barnett, Clinical Research Manager,
National Integrated Consortium for Breast Reconstruction Research
Phone: 416-340-4800 ext. 7434
Email: Heidi.Barnett@uhnresearch.ca