www.Imaginis.com
Imaginis.com is an independent American resource that provides information and news on breast cancer and related women's health topics. The section devoted to breast reconstruction is by comparison relatively limited, with only a small sample of images and diagrams to explain the mechanism of the outlined procedures. It fails to offer a thorough overview of all surgical options available and places too much emphasis on the patented ‘PEG procedure’ where replacement of the excised nipple–areolar complex is provided by a round ‘peg’ latissimus dorsi flap. It offers a link to a specific surgeon's web site where the procedure is offered and where more information can be gathered. Too much emphasis is placed on the financial implications of breast reconstruction and where to find an appropriately trained surgeon rather than on educating women on the benefits and risks of having reconstruction after cancer surgery.*
www.y-me.org
This web site is a charitable, national voluntary health organisation that was set up by breast cancer sufferers. It provides support and resources for patients with breast cancer with a small section for ‘survivors’ who are considering reconstruction. The site gives a good summary of the available surgical techniques, but it is relatively technical and does not provide any explanatory images. The site does briefly explain the advantages and disadvantages of reconstruction and implants, but it does not explain the benefits and risks associated with each individual procedure. There are links to some lay reviews on the Gluteal Artery Perforator (GAP) procedure and transcripts of interviews with surgeons. However, these are somewhat biased and not entirely clear. They also provide free ‘recycled’ wigs and prostheses to women of limited resources.**
www.mskcc.org
This is the web site for the Memorial Sloan-Kettering Cancer Center, New York offering a balanced and unbiased overview of the breast reconstruction options available to patients, and addressing the risk–benefit balance for each. It has diagrams to illustrate each procedure it explains, but these are small and of limited quality. The text is long-winded and, as result, it fails to highlight some of the key issues in breast reconstruction that patients considering the procedure should be aware of. It does not provide a selection of links for those patients interested in reading more on the topic and it is not as thorough as some of the other web sites available.***
www.cancerbackup.org.uk
Cancerbackup is a charitable resource that offers cancer patients and their families up-to-date information, practical advice and support on all cancers, including breast. The section devoted to breast reconstruction is thorough and guides the patient systematically through the process by defining the terminology in clear and concise sections with a good array of illustrative photographs. The site is much larger than others devoted to this topic; as a result, it contains sections on some of the issues concerning the timing of surgery, nipple reconstruction, lumpectomy, surgery to the contralateral breast and recovery. It provides a complete frequently asked questions (FAQs) section, and it references the information given on the web site appropriately. The level of information will also be useful to practicing surgeons who are keen to keep up-to-date on the current best practice in this field.****
www.cancer.gov
The National Cancer Institute (NCI) is a component of the US National Institutes of Health (NIH), and it is the Federal Government's principal agency for cancer research and training. This is an excellent cancer resource, offering information for both medical professionals and patients. However, although the information for doctors is well referenced, it is particularly limited with little explanation or information. The patient-centred pages expand a little more on the topic, but they are still inadequate for a patient requiring information on reconstructive surgery. It covers topics on tissue flaps, implants and it does offer a comprehensive list of questions that a patient should ask their surgeon if considering this procedure.***
www.breastcancer.org
Breastcancer.org is a non-profit organisation dedicated to providing the most reliable, complete, and up-to-date information about breast cancer. Although it is difficult to locate, it has a complete section devoted to reconstruction in lay-persons language, with celebrity audio recordings for difficult terminology. It is systematic in its approach, describing the different technical concepts of tissue expanders, autologous tissue flaps and nipple reconstruction with clear diagrams for the Transverse Rectus Abdominis Myocutaneous (TRAM) and latissimus dorsi flaps with a selection of photographs. It has a section where patients recount their personal experiences of reconstruction surgery, and there is also a FAQ section for women considering this surgery.***
www.cancer.org
The official website of the American Cancer Society, a nation-wide, community-based health organisation dedicated to eliminating cancer as a major health problem and eliminating suffering due to cancer. The subsection on breast cancer is easy to locate and comprehensive in its overview of reconstructive procedures. Each procedure is explained in detail in language suitable to the laymen. Patients' expectations are managed with several sections devoted to what to expect from reconstructive surgery and advice on ‘getting back to normal’. The site is let down by a lack of good quality images to support the descriptions of reconstructive procedures.***
http://qap.sdsu.edu/
The Cancer Clinical Services Quality Assurance Project (QAP) and The Center for Health Professional Education and Training (the Training Center provide this resource for healthcare providers involved in the early detection of breast and cervical cancers. The site provides information on every aspect of reconstruction from the clinicians' perspective. The advantages and disadvantages of immediate versus delayed reconstruction are explored. Expert opinion is provided through movie and audio clips. Descriptions of reconstructive procedures are supported with movie clips of postoperative patients. Overall, a good introductory site for the clinician wanting more information on breast reconstruction, but it is of limited value to advanced oncoloplastic surgeon.***
www.breasthealth.com.au
The official website of the National Breast Cancer Center (NBCC), which was set up in 1955 by the Australian Government as a means to support patients and their families through comprehensive information on breast and ovarian cancer. Information relating to breast reconstruction is provided in a questions and answers format. The information is patient-centred and practical issues are explored such as post reconstruction scarring, sensation and asymmetry. The advantages and disadvantages of implant over tissue transfer are given as a series of bullet points. However, there are no images at all on this site, which makes it harder to contextualise the descriptions of reconstructive procedures.**
www.breastcenter.com
The official web-page of The Center for Restorative Breast Surgery, founded by Dr Frank DellaCroce and Dr Scott Sullivan. It portrays a rather skewed view of breast reconstruction. Detailed descriptions supported by schematic images are only provided on deep inferior epigastric perforator (DIEP) flaps, superficial inferior epigastric artery (SIEA) flaps and the GAP flaps as these are the procedures provided by this clinic. TRAM flaps and implants are discussed primarily in terms of their disadvantages and complications.*
www.mayoclinic.com
The official website of the Mayo Clinic has a page dedicated to breast reconstruction. This is a patient-centred resource, which provides an unbiased comprehensive description of each technique. Useful information is provided on recovery times and what to expect following reconstruction. Schematic diagrams help to support the description of muscle flap reconstruction. The benefits and risks of each procedure and not discussed in length and there is little advice relating to early versus delayed reconstruction.**