Breast Implants and Breast Cancer Surveillance

Board Certified Female Plastic Surgeon Serving Las Vegas, Henderson and Nearby Areas of Nevada

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One in 8 women develop breast cancer. Breast cancer is the second leading cause of death in females. So women who are contemplating breast augmentation surgery need to know about any increased risks of developing breast cancer. It is also important to know whether or not their silicone or saline breast implant will hinder their ability to detect breast cancer by self- exam or mammography.
The majority of the literature shows that women with breast implants are NOT at risk for not being able to detect breast cancer at an early stage. In addition, saline or silicone breast implants DO NOT cause breast cancer.

More recently, the media has reported on a just published study evaluating whether cosmetic breast augmentation has an effect on early detection of breast cancer. This is a Meta-analysis, meaning it is a review of 12 studies previously published and lumped together. Meta-analysis studies should always be interpreted with caution, as bias is common, and it is difficult to account for different patient characteristics in each study that confound the evidence. For example, patient age and patient weight was not taken into account, and these 2 patient characteristics affect breast cancer detection and survival to a high degree, and probably more so than the presence of an implant. Although this is the first review in a long time suggesting that breast implants adversely affect the survival of women with breast cancer, these findings need to be interpreted with caution. In the final conclusions section of the study, the authors explain that despite their data obtained by statistical analysis, NO conclusion regarding breast cancer survival can be drawn, and the authors advise continued follow up to further evaluate this relevant question.

If you have breast implants and are undergoing routine or diagnostic mammography, you will have 2 extra pictures taken per side in order to see as much breast tissue as possible. In these extra x-ray pictures, called implant displacement (ID) views or Ekland views, the implant is “pushed back” against the chest wall and the breast is pulled forward over it. This allows better imaging of the front part of each breast. Implant displacement views do not work as well in women who have had hard scar tissue form around the implants (contractures). They are easier in women whose implants are placed underneath (behind) the chest muscles. There is an insignificant risk of implant rupture associated with mammograms; benefits far outweigh any sort of risk.
If an area of breast tissue is not adequately evaluated by routine mammography, then Ultrasound, MRI, or biopsy can be used.It is important that your radiologist and imaging technician are experienced examining women with breast implants. In Las Vegas, that is not a problem, as a high proportion of women here have breast implants.

On the plus side, women with breast implants tend to be very in-tune with their self-exams. Many perform routine massage. The breast implant sits behind the breast tissue and pushes it forward, facilitating routine self-exam. In addition, women who have silicone implants are monitored for implant rupture by serial MRIs per FDA recommendations. Although mammograms are the best way to see breast tissue, women undergoing MRIs to check the status of their implants may have an advantage when it comes to being able to detect breast cancer at an early stage.

Patients with a very strong family history of breast cancer, or those who are positive for the BRCA gene should strongly consider NOT undergoing cosmetic breast augmentation. All breast augmentation patients must be diligent with routine self-exams, mammography, MRI and/or Ultrasound per American Cancer Society Guidelines:

http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-acs-recs

Dr. Hayley Brown MD, FACS
Board Certified Plastic Surgeon
Desert Hills Plastic Surgery Center serving Henderson and Las Vegas, Nevada

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