Priority 14 from the Post Mastectomy Breast Reconstruction PSP

UNCERTAINTY: What is the evidence behind implants and the development of anaplastic large cell lymphoma (ALCL) and breast implant illness? (JLA PSP Priority 14)
Overall ranking	14
JLA question ID	0109/14
Explanatory note	Not available for this PSP
Evidence	Different types of implants for reconstructive breast surgery. Rocco, Nicola. Rispoli, Corrado. Moja, Lorenzo. Amato, Bruno. Iannone, Loredana. Testa, Serena. Spano, Andrea. Catanuto, Giuseppe. Accurso, Antonello. Nava, Maurizio B. Cochrane Database of Systematic Reviews. 5, 2016. Acellular dermal matrices for breast reconstruction surgery. Rolph, Rachel. Duffy, MN James. Mehta, Saahil N. TanKoay, Grace Ava. Farhadi, Jian. Cochrane Database of Systematic Reviews. 12, 2015. Breast reconstruction following prophylactic or therapeutic mastectomy for breast cancer. Alberta Health Services - Cancer Care Published on: 2017-02. Breast cancer reconstruction surgery (immediate and delayed) across Ontario: patient indications and appropriate surgical options. Cancer Care Ontario's Program in Evidence-based Care Published on: 2016-01.
Health Research Classification System category	Cancer

Extra information provided by this PSP
Original uncertainty examples	The skin over an implant often feels cold to touch. You may or may not have much sensation ~ How do I know if my implant is leaking or there is too much scar tissue building up? ~ With implants, are they likely to need revisions? ~ However a few have had their implants removed as there was research that revealed that there was an increased chance of developing a secondary type of cancer, so they wanted to be pro active and have them removed
Submitted by	57 x Patients or Care-givers, 3 x Clinicians

Extra information provided by this PSP

Original uncertainty examples

The skin over an implant often feels cold to touch. You may or may not have much sensation ~ How do I know if my implant is leaking or there is too much scar tissue building up? ~ With implants, are they likely to need revisions? ~ However a few have had their implants removed as there was research that revealed that there was an increased chance of developing a secondary type of cancer, so they wanted to be pro active and have them removed

Submitted by

57 x Patients or Care-givers, 3 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