Canadian Expert Opinion on Breast Reconstruction Access: Strategies to Optimize Care during COVID-19

Kathryn V. Isaac, MD, MPH; Edward W. Buchel, MD; Muriel M. Brackstone, MD, MSc, PhD; Christopher Doherty, MD, MPH; Joan E. Lipa, MD, MSc; Toni Zhong, MD, MHS; John L. Semple, MD, MSc; Mitchell H. Brown, MD, MEd; Laura Snell, MD, MSc; Mary-Helen Mahoney, MD; Joshua Vorstenbosch, MD, PhD; Margaret Wheelock, MD; Sheina A. Macadam, MD, MHS; Christopher J. Coroneos, MD, MSc; Marie-Pascale Tremblay-Champagne, MD; Sophocles H. Voineskos, MD, MSc; Jing Zhang, MD, PhD; Ron Somogyi, MD, MSc; Claire Temple-Oberle, MD, MSc; Douglas Ross, MD, MEd

doi:10.1097/GOX.0000000000004204

Plastic and Reconstructive Surgery, Global Open (Feb 2022)

Canadian Expert Opinion on Breast Reconstruction Access: Strategies to Optimize Care during COVID-19

Kathryn V. Isaac, MD, MPH,
Edward W. Buchel, MD,
Muriel M. Brackstone, MD, MSc, PhD,
Christopher Doherty, MD, MPH,
Joan E. Lipa, MD, MSc,
Toni Zhong, MD, MHS,
John L. Semple, MD, MSc,
Mitchell H. Brown, MD, MEd,
Laura Snell, MD, MSc,
Mary-Helen Mahoney, MD,
Joshua Vorstenbosch, MD, PhD,
Margaret Wheelock, MD,
Sheina A. Macadam, MD, MHS,
Christopher J. Coroneos, MD, MSc,
Marie-Pascale Tremblay-Champagne, MD,
Sophocles H. Voineskos, MD, MSc,
Jing Zhang, MD, PhD,
Ron Somogyi, MD, MSc,
Claire Temple-Oberle, MD, MSc,
Douglas Ross, MD, MEd

Affiliations

Kathryn V. Isaac, MD, MPH: From the * Division of Plastic Surgery, University of British Columbia, Vancouver, BC, Canada
Edward W. Buchel, MD: † Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
Muriel M. Brackstone, MD, MSc, PhD: ‡ Department of Surgical Oncology, London Health Sciences Centre, London, ON, Canada
Christopher Doherty, MD, MPH: From the * Division of Plastic Surgery, University of British Columbia, Vancouver, BC, Canada
Joan E. Lipa, MD, MSc: § Department of Surgery, University of Toronto, Toronto, ON, Canada
Toni Zhong, MD, MHS: § Department of Surgery, University of Toronto, Toronto, ON, Canada
John L. Semple, MD, MSc: § Department of Surgery, University of Toronto, Toronto, ON, Canada
Mitchell H. Brown, MD, MEd: ∥ Division of Plastic Surgery, Women’s College Hospital, Toronto, ON, Canada
Laura Snell, MD, MSc: § Department of Surgery, University of Toronto, Toronto, ON, Canada
Mary-Helen Mahoney, MD: § Department of Surgery, University of Toronto, Toronto, ON, Canada
Joshua Vorstenbosch, MD, PhD: ** Division of Plastic and Reconstructive Surgery, McGill University, Montreal, QC, Canada
Margaret Wheelock, MD: †† Division of Plastic Surgery, Dalhousie University, Halifax, NS, Canada
Sheina A. Macadam, MD, MHS: From the * Division of Plastic Surgery, University of British Columbia, Vancouver, BC, Canada
Christopher J. Coroneos, MD, MSc: ‡‡ Division of Plastic Surgery, McMaster University, Hamilton, ON, Canada
Marie-Pascale Tremblay-Champagne, MD: §§ Department of Surgery, Université de Montréal, Montreal, QC, Canada
Sophocles H. Voineskos, MD, MSc: ‡‡ Division of Plastic Surgery, McMaster University, Hamilton, ON, Canada
Jing Zhang, MD, PhD: ∥∥ Division of Plastic Surgery, University of Ottawa, Ottawa, ON, Canada
Ron Somogyi, MD, MSc: ‡ Department of Surgical Oncology, London Health Sciences Centre, London, ON, Canada
Claire Temple-Oberle, MD, MSc: *** Department of Surgery and Oncology, University of Calgary, Calgary, AB, Canada
Douglas Ross, MD, MEd: ††† Division of Plastic and Reconstructive Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.

DOI: https://doi.org/10.1097/GOX.0000000000004204
Journal volume & issue: Vol. 10, no. 2
p. e4204

Abstract

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Background:. Breast reconstructive services are medically necessary, time-sensitive procedures with meaningful health-related quality of life benefits for breast cancer survivors. The COVID-19 global pandemic has resulted in unprecedented restrictions in surgical access, including access to breast reconstructive services. A national approach is needed to guide the strategic use of resources during times of fluctuating restrictions on surgical access due to COVID-19 demands on hospital capacity. Methods:. A national team of experts were convened for critical review of healthcare needs and development of recommendations and strategies for patients seeking breast reconstruction during the pandemic. Following critical review of literature, expert discussion by teleconference meetings, and evidenced-based consensus, best practice recommendations were developed to guide national provision of breast reconstructive services. Results:. Recommendations include strategic use of multidisciplinary teams for patient selection and triage with centralized coordinated use of alternate treatment plans during times of resource restrictions. With shared decision-making, patient-centered shifting and consolidation of resources facilitate efficient allocation. Targeted application of perioperative management strategies and surgical treatment plans maximize the provision of breast reconstructive services. Conclusions:. A unified national approach to strategically reorganize healthcare delivery is feasible to uphold standards of patient-centered care for patients interested in breast reconstruction.

Published in Plastic and Reconstructive Surgery, Global Open

ISSN: 2169-7574 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://www.prsgo.com

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