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Unit outline_

SURG5040: Breast Reconstruction Techniques

Semester 2, 2024 [Online] - Camperdown/Darlington, Sydney

This unit of study concludes the specialist breast surgery curriculum. The focus is on breast reconstruction after mastectomy. It includes the full range of breast reconstruction techniques - implant based reconstruction, latissimus dorsi reconstruction and free flap tissue options – as well as lipofilling and nipple reconstruction techniques. Students will participate in multi-surgeon meeting case discussions with complex decision-making and management of complications.

Unit details and rules

Academic unit Surgery
Credit points 6
Prerequisites
? 
SURG5037 and SURG5038 and SURG5039
Corequisites
? 
None
Prohibitions
? 
None
Assumed knowledge
? 

This unit is designed as the forth and final part of a curriculum for contemporary breast surgery for Post Fellowship Trainees and assumes practical skills training is obtained on the BreastSurgANZ PFT Program (or equivalent). Applicants must have completed general or plastic surgical training and have a strong interest in breast surgery

Available to study abroad and exchange students

No

Teaching staff

Coordinator Samriti Sood, samriti.sood@sydney.edu.au
The census date for this unit availability is 2 September 2024
Type Description Weight Due Length
Assignment Publication report: final report
Report
20% Formal exam period
Due date: 11 Nov 2024 at 23:59
2000 words
Outcomes assessed: LO6 LO7 LO8 LO9 LO10 LO11 LO12 LO14 LO15 LO16 LO19
Small continuous assessment Audio assignment 1 and 2
Recorded presentation
20% Multiple weeks 10 minutes each
Outcomes assessed: LO1 LO19 LO18 LO17 LO10 LO9 LO8 LO7 LO6 LO5 LO4 LO3 LO2
Assignment Publication report: clinical case discussion
Written task
10% Week 04
Due date: 25 Aug 2024 at 23:59
500 words + peer reply
Outcomes assessed: LO6 LO19 LO16 LO15 LO14 LO12 LO11 LO10 LO9 LO8 LO7
Assignment Case Study Report 1
Case study
15% Week 05
Due date: 01 Sep 2024 at 23:59
2000 words
Outcomes assessed: LO13
Assignment Publication report: literature review
Written case
10% Week 08
Due date: 22 Sep 2024 at 23:59
500-750 words
Outcomes assessed: LO6 LO19 LO16 LO15 LO14 LO12 LO11 LO10 LO9 LO8 LO7
Assignment Case Study Report 2
Case study
15% Week 11
Due date: 20 Oct 2024 at 23:59
2000 words
Outcomes assessed: LO13
Assignment Clinical case discussion
Discussion contribution
10% Week 13
Due date: 03 Nov 2024 at 23:59
500 words + peer reply
Outcomes assessed: LO1 LO19 LO18 LO17 LO10 LO9 LO8 LO7 LO6 LO5 LO4 LO3 LO2

Assessment summary

  • Audio assignment 1 and 2: Students will be asked to prepare an audio response to a multifaceted question.
  • Case study report 1 and 2: There will be 2 case study reports. In each one, students will be presented with 3 patients and asked to plan the breast cancer surgery of each patient.
  • Clinical case discussion: In this discussion, students will be asked to respond to the questions posed. There are 2 discussions throughout the semester and students are required to post a response to every case discussion. The module 4 discussion will be based on the student’s publication report. Students will be asked to present a potential case they would like to prepare their publication on and use the discussion board to receive feedback on the case. Once submitted, students will have access to other students’ answers and will be required to comment on another students’ answer.
  • Publication report - clinical case discussion: Based on the case presented in the publication report (case discussion) assessment students will be asked to prepare a literature review on their potential case in the publication report (literature review) assessment.
  • Publication report – literature review: Based on the case presented in the publication report (case discussion) assessment students will be asked to prepare a literature review on your potential case in the publication report (literature review) assessment.
  • Publication report – final report: Following feedback from the case discussion and literature review students will be asked to present a publication.

Detailed information for each assessment can be found on Canvas.

Assessment criteria

The University awards common result grades, set out in the Coursework Policy 2014 (Schedule 1).

As a general guide, a high distinction indicates work of an exceptional standard, a distinction a very high standard, a credit a good standard, and a pass an acceptable standard.

Result name

Mark range

Description

High distinction

85 - 100

 

Distinction

75 - 84

 

Credit

65 - 74

 

Pass

50 - 64

 

Fail

0 - 49

When you don’t meet the learning outcomes of the unit to a satisfactory standard.

For more information see sydney.edu.au/students/guide-to-grades.

For more information see guide to grades.

Late submission

In accordance with University policy, these penalties apply when written work is submitted after 11:59pm on the due date:

  • Deduction of 5% of the maximum mark for each calendar day after the due date.
  • After ten calendar days late, a mark of zero will be awarded.

Academic integrity

The Current Student website provides information on academic integrity and the resources available to all students. The University expects students and staff to act ethically and honestly and will treat all allegations of academic integrity breaches seriously.

We use similarity detection software to detect potential instances of plagiarism or other forms of academic integrity breach. If such matches indicate evidence of plagiarism or other forms of academic integrity breaches, your teacher is required to report your work for further investigation.

Use of generative artificial intelligence (AI) and automated writing tools

You may only use generative AI and automated writing tools in assessment tasks if you are permitted to by your unit coordinator. If you do use these tools, you must acknowledge this in your work, either in a footnote or an acknowledgement section. The assessment instructions or unit outline will give guidance of the types of tools that are permitted and how the tools should be used.

Your final submitted work must be your own, original work. You must acknowledge any use of generative AI tools that have been used in the assessment, and any material that forms part of your submission must be appropriately referenced. For guidance on how to acknowledge the use of AI, please refer to the AI in Education Canvas site.

The unapproved use of these tools or unacknowledged use will be considered a breach of the Academic Integrity Policy and penalties may apply.

Studiosity is permitted unless otherwise indicated by the unit coordinator. The use of this service must be acknowledged in your submission as detailed on the Learning Hub’s Canvas page.

Outside assessment tasks, generative AI tools may be used to support your learning. The AI in Education Canvas site contains a number of productive ways that students are using AI to improve their learning.

Simple extensions

If you encounter a problem submitting your work on time, you may be able to apply for an extension of five calendar days through a simple extension.  The application process will be different depending on the type of assessment and extensions cannot be granted for some assessment types like exams.

Special consideration

If exceptional circumstances mean you can’t complete an assessment, you need consideration for a longer period of time, or if you have essential commitments which impact your performance in an assessment, you may be eligible for special consideration or special arrangements.

Special consideration applications will not be affected by a simple extension application.

Using AI responsibly

Co-created with students, AI in Education includes lots of helpful examples of how students use generative AI tools to support their learning. It explains how generative AI works, the different tools available and how to use them responsibly and productively.

Support for students

The Support for Students Policy 2023 reflects the University’s commitment to supporting students in their academic journey and making the University safe for students. It is important that you read and understand this policy so that you are familiar with the range of support services available to you and understand how to engage with them.

The University uses email as its primary source of communication with students who need support under the Support for Students Policy 2023. Make sure you check your University email regularly and respond to any communications received from the University.

Learning resources and detailed information about weekly assessment and learning activities can be accessed via Canvas. It is essential that you visit your unit of study Canvas site to ensure you are up to date with all of your tasks.

If you are having difficulties completing your studies, or are feeling unsure about your progress, we are here to help. You can access the support services offered by the University at any time:

Support and Services (including health and wellbeing services, financial support and learning support)
Course planning and administration
Meet with an Academic Adviser

WK Topic Learning activity Learning outcomes
Week 01 Module 1: breast implants Online class (10 hr)  
Week 02 Module 2: lipodermal flaps, ADMs and other meshes Online class (10 hr)  
Week 03 Module 3: coordinating timing of breast reconstruction Online class (10 hr)  
Week 04 Module 4: implant based reconstruction - principles and techniques Online class (10 hr)  
Week 05 Module 5: implant based reconstruction - 1 stage vs 2 stage Online class (10 hr)  
Week 06 Module 6: implant based reconstruction - managing complications Online class (10 hr)  
Week 07 Module 7: lipofilling Online class (10 hr)  
Week 08 Module 8: contralateral mammoplasty/augmentation for symmetry Online class (10 hr)  
Week 09 Module 9: latissimus dorsi reconstruction and extended LD Online class (10 hr)  
Week 10 Module 10: principles of perforator flap and microsurgery Online class (10 hr)  
Week 11 Module 11: nipple reconstruction Online class (10 hr)  
Week 12 Module 12: difficult case series Online class (10 hr)  
Week 13 Module 13: novel equipment in breast reconstruction Online class (10 hr)  
Week 14 (STUVAC) Module 14: reporting outcomes Online class (10 hr)  

Attendance and class requirements

There will be a webinar during the semester, students are encouraged to attend and contribute to case discussion.

Study commitment

Typically, there is a minimum expectation of 1.5-2 hours of student effort per week per credit point for units of study offered over a full semester. For a 6 credit point unit, this equates to roughly 120-150 hours of student effort in total.

Required readings

All readings for this unit can be accessed through Canvas.

Learning outcomes are what students know, understand and are able to do on completion of a unit of study. They are aligned with the University's graduate qualities and are assessed as part of the curriculum.

At the completion of this unit, you should be able to:

  • LO1. understand the types of implants available and the mechanisms of determining size proportions and volume
  • LO2. understand the methods and limitations of determining size of implants for an individual patient
  • LO3. understand the range of available alternatives, and fundamentals of how lipodermal flaps, ADMs and other synthetic meshes may facilitate implant based reconstruction
  • LO4. understand the subtleties of selection of lipodermal flaps, ADMs or other meshes and the circumstances where each might be used
  • LO5. understand the individual features and origins of the different ADMs and meshes that are commonly available in ANZ
  • LO6. understand the surgical and multidisciplinary pressures that influence the options for immediate versus delayed breast reconstruction including the breadth and limitations of existing evidence in this area and the inability to conduct randomised clinical trials to improve the evidence base
  • LO7. understand the importance of appropriate audit of results - the quality of life impact of BR need to be recognised and the reasonable likelihood that those patients directed toward DBR will never have BR
  • LO8. understand the fundamentals of how to perform implant based reconstruction - discuss 1 and 2 stage implant reconstruction and benefits/limitations of each
  • LO9. discuss the benefits and issues with use of ADMs or not with 1 and 2 stage reconstruction
  • LO10. understand the immediate, short-term and long-term complications of implant based reconstruction and the management of these complications - you should be aware of strategies to avoid complications of implant BR - ASPS/ASCPS 14 point plan and you should be aware of the signs and patterns of complications including ALCL after implant based BR
  • LO11. understand the timing, principles of the surgery, common techniques available and complications associated with contralateral symmetry procedures after breast reconstruction
  • LO12. understand the anatomical basis for LD reconstruction - you should understand the fat distribution around the lat dorsi muscle and adjacent regions of fat zones and how they might be utilised in extended LD recon and you should understand the steps involved in an LD recon
  • LO13. understand the techniques and variations in technique for lipofilling - be aware of the evolving applications of lipofilling and understand the science of lipofilling - irrigation, local anaesthetic, centrifugation, take rates
  • LO14. understand the principles of pedicled and perforator flap breast reconstruction surgery, the range of options and selection of the appropriate option, long term outcomes and morbidity for available options and the planning for and execution of DIEP and TRAM breast reconstruction
  • LO15. understand plastic surgeons' preferences for breast surgeons' incisions and timing of reconstruction - opinions on DIEP/TRAM after chemo and chemo/RT
  • LO16. understand some of the subtleties of the less common options of autologous BR
  • LO17. understand case selection and timing across the range of reconstruction options
  • LO18. understand the emerging technologies of imaging BR and assessing skin flaps after SSM and NSM as well as measuring aesthetic outcomes from breast surgery and breast reconstruction - including from the patient’s perspective
  • LO19. understand quality of life measurement after breast surgery and breast reconstruction including PROMs.

Graduate qualities

The graduate qualities are the qualities and skills that all University of Sydney graduates must demonstrate on successful completion of an award course. As a future Sydney graduate, the set of qualities have been designed to equip you for the contemporary world.

GQ1 Depth of disciplinary expertise

Deep disciplinary expertise is the ability to integrate and rigorously apply knowledge, understanding and skills of a recognised discipline defined by scholarly activity, as well as familiarity with evolving practice of the discipline.

GQ2 Critical thinking and problem solving

Critical thinking and problem solving are the questioning of ideas, evidence and assumptions in order to propose and evaluate hypotheses or alternative arguments before formulating a conclusion or a solution to an identified problem.

GQ3 Oral and written communication

Effective communication, in both oral and written form, is the clear exchange of meaning in a manner that is appropriate to audience and context.

GQ4 Information and digital literacy

Information and digital literacy is the ability to locate, interpret, evaluate, manage, adapt, integrate, create and convey information using appropriate resources, tools and strategies.

GQ5 Inventiveness

Generating novel ideas and solutions.

GQ6 Cultural competence

Cultural Competence is the ability to actively, ethically, respectfully, and successfully engage across and between cultures. In the Australian context, this includes and celebrates Aboriginal and Torres Strait Islander cultures, knowledge systems, and a mature understanding of contemporary issues.

GQ7 Interdisciplinary effectiveness

Interdisciplinary effectiveness is the integration and synthesis of multiple viewpoints and practices, working effectively across disciplinary boundaries.

GQ8 Integrated professional, ethical, and personal identity

An integrated professional, ethical and personal identity is understanding the interaction between one’s personal and professional selves in an ethical context.

GQ9 Influence

Engaging others in a process, idea or vision.

Outcome map

Learning outcomes Graduate qualities
GQ1 GQ2 GQ3 GQ4 GQ5 GQ6 GQ7 GQ8 GQ9

This section outlines changes made to this unit following staff and student reviews.

We value your feedback about any aspect of the unit of study and your experience as a student of Sydney Medical School. To help ensure our courses meet your needs and maintain a high standard, we welcome your feedback at any time and we ask you to complete the Mid-Semester Evaluation Survey and the Unit of Study Survey at the end of the semester. You can also rate any component of the unit using our star rating system found at the bottom of many pages as you progress through the unit. Your ratings and comments are anonymous and specifying what you liked and didn’t like about any of the learning materials, assessment items, discussion forums, feedback etc will help us to target our improvement efforts. Please note that your participation in this unit of study permits de-identified information about your learning experience and interaction with learning resources to be used for the purpose of improving the student learning experience.

Disclaimer

The University reserves the right to amend units of study or no longer offer certain units, including where there are low enrolment numbers.

To help you understand common terms that we use at the University, we offer an online glossary.