Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Risk and Associated Product Recall Approach: Description of a Patient-Centered Multidisciplinary Information, Decision Aid and Support Structure
Bibliographic record
Abstract
Introduction: Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare form of cancer mainly associated with textured breast implants and tissue expanders recalled in early 2019 in Canada. Currently, there are no consensus and no shared best practices to approach the BIA-ALCL associated social and psychological implications. This article aims to share the CHU de Québec-Université Laval’s practice in taking its social responsibility and approaching the BIA-ALCL associated recall as well as its psychological implications. Materials and methods: The patient-centered multidisciplinary information, decision aid, and support structure that was put in place is described and comprises: a dedicated support phone line with staff members answering on business hours; an information and psycho-education group intervention specifically developed to inform, reassure and guide patients at risk of BIA-ALCL; a consultation with a member of the psycho-oncology team for decision aid and emotional support if desired; and a consultation with a plastic surgeon if desired. Results: Women at risk of BIA-ALCL’s needs were met by the support phone line, group interventions, and consultations with plastic surgeons. Patient experience questionnaire analysis related to the group intervention shows that it is judged worth it, acceptable and relevant in the BIA-ALCL context and shows lower levels of distress, anxiety, depression, and information needs after the intervention. Discussion: Women at risk of developing BIA-ALCL have important information and emotional needs that need to be addressed with a patient-centered multidisciplinary tailored approach to help them cope and support them in making informed decisions. Conclusion: The shared model of practice, a support structure enabling access to individual and group interventions, allows to meet the needs of women at risk of BIA-ALCL, by providing relevant information, helping them cope with associated negative emotions and support them through their decision-making process.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".