Are the media reports true? What is the real risk of breast implants?
Recent media reports have quoted a study that analysed the results of 12 studies published after 1993 in the US, Europe and Canada. The objectives were to evaluate whether the stage at which breast cancer was detected differs among women with breast implants and those with no implants and whether breast augmentation before the detection of breast cancer is a predictor of post diagnosis survival.
The research showed that women with implants had a 26% increased risk of being diagnosed at a later stage of breast cancer than women without. It also showed that women with implants had a 38% higher risk of death from breast cancer than those without.
Why would this be?
The finding of later stage tumours at diagnosis can be explained by multiple mechanisms :
Both silicone and saline implants create radio-opaque shadows on mammograms which impair visualization of breast tissue.
Capsular contraction, which can develop in up to 20% of women with implants, can reduce sensitivity to mammograms by 30-50%
Characteristics of breast implants might affect the detection of breast cancer – implants placed under the breast glands are suspected to obstruct mammographic visualisation more than submuscular implants because of their proximity with the breast tissue.
The obstruction to the mammograms may lead to cancers being detected only in the later stages which can often lead to worse outcomes. This can explain the increased risk of late detection and death from breast cancer in those women with breast implants compared to those without.
The authors of the study found that, in conclusion, the results shown by the meta-analysis are not conclusive and should be followed up by further evaluation and research. What is highlighted by this research is that mammograms are not enough to detect breast cancer in patients with breast implants and therefore other methods of screening are necessary.
Despite this important piece of research it is worth remembering that large epidemiological studies have found that women with breast implants actually have a mildly lower risk of developing breast cancer in the first place. At London Bridge Plastic Surgery, we recommend that all of our patients over the age of 40 years have a mammogram before breast implant surgery and have this repeated 1 year following their implant.
It is also very important that all women with breast implants over the age of 40 years should have a mammogram combined with an ultrasound scan to ensure that their breast is adequately visualized. With modern digital mammograms and ultrasound imaging, women with breast implants should have no greater risk of later diagnosis than women without implants.