Users' guide to the surgical literature: how to assess an article about harm in surgery.
You are a new plastic surgeon in the community and you are referred a patient interested in breast reconstruction. The patient is a 35-year-old female school teacher who had a bilateral prophylactic mastectomy 2 years earlier, as she was a BRCA gene carrier. Since she is of a petite build with very little subcutaneous tissue or extra skin in the lower abdomen, you decide that she is not a suitable candidate for an abdomen-based autologous tissue reconstruction. You recommend the technique of tissue expansion and silicone gel implants. She is concerned, however, about the possibility of anaplastic large cell lymphoma (ALCL) developing in her breasts. She read in a magazine recently that ALCL, an unusual form of breast cancer, has been occurring in patients who have breast implants. She is very concerned that she might be at risk and asks for your opinion as to whether she should proceed with the procedure or not.
From the Division of Plastic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Levis); the Surgical Outcomes Research Center, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Kaur, Levis, Lovrics, Goldsmith, Farrokhyar); the Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Farrokhyar, Goldsmith); the School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Kaur); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Waltho); the Division of General Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Lovrics); the Faculty of Health Sciences, Simon Fraser University, Vancouver, BC (Goldsmith).
Achilleas
A
Thoma
From the Division of Plastic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Levis); the Surgical Outcomes Research Center, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Kaur, Levis, Lovrics, Goldsmith, Farrokhyar); the Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Farrokhyar, Goldsmith); the School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Kaur); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Waltho); the Division of General Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Lovrics); the Faculty of Health Sciences, Simon Fraser University, Vancouver, BC (Goldsmith).
Manraj Nirmal
MN
Kaur
From the Division of Plastic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Levis); the Surgical Outcomes Research Center, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Kaur, Levis, Lovrics, Goldsmith, Farrokhyar); the Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Farrokhyar, Goldsmith); the School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Kaur); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Waltho); the Division of General Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Lovrics); the Faculty of Health Sciences, Simon Fraser University, Vancouver, BC (Goldsmith).
Forough
F
Farrokhyar
From the Division of Plastic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Levis); the Surgical Outcomes Research Center, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Kaur, Levis, Lovrics, Goldsmith, Farrokhyar); the Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Farrokhyar, Goldsmith); the School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Kaur); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Waltho); the Division of General Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Lovrics); the Faculty of Health Sciences, Simon Fraser University, Vancouver, BC (Goldsmith).
Daniel
D
Waltho
From the Division of Plastic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Levis); the Surgical Outcomes Research Center, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Kaur, Levis, Lovrics, Goldsmith, Farrokhyar); the Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Farrokhyar, Goldsmith); the School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Kaur); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Waltho); the Division of General Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Lovrics); the Faculty of Health Sciences, Simon Fraser University, Vancouver, BC (Goldsmith).
Carolyn
C
Levis
From the Division of Plastic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Levis); the Surgical Outcomes Research Center, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Kaur, Levis, Lovrics, Goldsmith, Farrokhyar); the Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Farrokhyar, Goldsmith); the School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Kaur); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Waltho); the Division of General Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Lovrics); the Faculty of Health Sciences, Simon Fraser University, Vancouver, BC (Goldsmith).
Peter
P
Lovrics
From the Division of Plastic Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Levis); the Surgical Outcomes Research Center, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Kaur, Levis, Lovrics, Goldsmith, Farrokhyar); the Department of Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Thoma, Farrokhyar, Goldsmith); the School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Kaur); the Faculty of Medicine, University of Ottawa, Ottawa, Ont. (Waltho); the Division of General Surgery, Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Lovrics); the Faculty of Health Sciences, Simon Fraser University, Vancouver, BC (Goldsmith).
Charlie H
CH
Goldsmith
D000328:Adult; D005260:Female; D013502:General Surgery / Q000379:methods / Q000592:standards*; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects; D010043:Outcome and Process Assessment, Health Care / Q000379:methods* / Q000592:standards; D017410:Practice Guidelines as Topic; D018570:Risk Assessment / Q000379:methods* / Q000592:standards; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
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