STUDY: Breast cancer and implants

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A new study has revealed that breast augmentation with implants does not interfere with the ability to detect later breast cancers, and tumors may be detected at a smaller size in breasts containing implants.

The study, published in the April issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons, also found that mammography may be less likely to detect cancers in breasts with implants.

Michael Sosin, MD, of MedStar Georgetown University Hospital, in Washington, D.C., along with his colleagues, discovered differences in breast cancer diagnosis and treatment in women who have had breast augmentation, including a higher rate of mastectomy.

The study included 48 patients with breast cancer developing after breast augmentation, and a group of 302 women with breast cancer who did not have breast implants.

Researchers found that, at diagnosis, tumors were significantly smaller in women with breast implants. In patients whose cancers were detected by the discovery of a palpable mass–by either breast self-exam or clinical exam–the average tumor size was significantly smaller in the breast augmentation group than in the comparison group.

However, the rate of tumor detection by screening mammograms was lower for women who had implants.

Regarding the differences in subsequent breast cancer diagnosis and treatment, researchers found that women with implants were more likely to undergo excisional biopsy and less likely to undergo imaging-guided core needle biopsy. They were also more likely to be treated with mastectomy.

The detection of breast cancer detection was unaffected by the type of breast implant (silicone- versus saline-filled), or whether the implant was placed over or under the pectoral muscle. However, researchers found evidence suggesting that mammographic detection was more likely in breasts with saline-filled versus silicone-filled implants.

An estimated 1 in 8 women will develop breast cancer during their lives, while almost 300,000 women undergo breast augmentation each year. Although studies have clearly indicated that breast implants do not increase the risk of breast cancer, there are continued concerns that implants might lead to delayed diagnosis.

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