Are Breast Implants Anticarcinogenic? A 14-Year Follow-Up of the Los Angeles Study

Abstract

Endothelins are well-known vasoconstrictor peptides produced by vascular endothelial cells that have been reported to have a fundamental role in regulation of the systemic blood circulation. Plasma levels of endothelins are increased by burn injury, which also causes thrombosis and occlusion of vessels in the dermis as well as a vascular response in the adjacent uninjured dermis. Diminished blood flow leads to progressive ischemia and necrosis of the dermis beneath and around the burn (zone of stasis). If blood flow could be restored in this zone, secondary tissue damage would be minimized. In this study we examined the effects of a new nonselective endothelin receptor antagonist, TAK-044 (Takeda Chemical Industries, Ltd., Osaka, Japan), on burn trauma in rats. Fifty male Sprague-Dawley rats weighing an average of 450 gm were burned with a brass probe that produced a row of three burns 10 x 30 mm in size and two intervening unburned areas 5 x 30 mm in size. Rats were divided into five groups of 10 animals. Four groups received 0.01, 0.1, 1 or 10 mg/kg of TAK-044 via the dorsal vein of the penis immediately after burn trauma, while the control group received the same volume of saline. Skin blood flow was measured with a laser-Doppler flowmeter, and the development of edema and the area of necrotic tissue also were determined. Inhibition of endothelin activity by TAK-044 after burn injury improved microvascular perfusion in the zone of stasis and prevented the progression of tissue damage in this zone. This supports the role of endothelins in the progression of burn injury in the zone of stasis. TAK-044 was most effective in preventing progressive burn damage at a dose of 1 mg/kg. The extent of necrosis and edema was reduced significantly, and blood flow in the zone of stasis was increased in the treated rats.

Stage of breast cancer at diagnosis among women with cosmetic breast implants

“…Others have reported similar findings and concluded that women with cosmetic breast implants are not at increased risk of subsequent breast cancer (Berkel et al, 1992;Deapen et al, 1997;McLaughlin et al, 1998;Brinton et al, 2000b); on the contrary, a recent metaanalysis reported a 30% reduction of breast cancer risk among women with breast implants (RR ¼ 0.72; 95% CI 0.61 -0.85) and it was concluded that breast implants may confer a protective effect against breast cancer (Hoshaw et al, 2001). Several explanations for this protective effect have been put forward: activation of the immune response as result of foreign body reaction may enhance detection and degradation of precancerous lesions; compression of the glandular tissue from the implant may diminish blood perfusion, which may alter cellular metabolism, and a local decrease in body temperature caused by the implant could diminish cellular metabolism (Deapen et al, 1997;Brinton et al, 2000b;Hoshaw et al, 2001). However, different preoperative characteristics among women seeking breast implantation compared with other women could perhaps more likely account for the decreased breast cancer risk among implant women.…”

“…There is no evidence that breast implants increase the risk of breast cancer (Brinton et al, 2000b;Mellemkjaer et al, 2000). On the contrary, several reports document that women with cosmetic breast implants seem to be at a lower risk of developing breast cancer (Berkel et al, 1992;Deapen et al, 1997;McLaughlin et al, 1998;Hoshaw et al, 2001). However, the issue of potential delay in breast cancer diagnosis in the augmented breast has been raised, since breast implants are radiopaque and this influences the sensitivity of mammography (Eklund et al, 1988;Hayes et al, 1988;Silverstein et al, 1992).…”

Do Breast Implants Adversely Affect Prognosis among Those Subsequently Diagnosed with Breast Cancer? Findings from an Extended Follow-Up of a Canadian Cohort

“…Only 3 publications, including our previous report, showed a statistically significant shift toward more advanced breast tumors at diagnosis among augmented women (19)(20)(21). However, several other publications reported no statistically significant differences in breast cancer stage at diagnosis comparing augmented to nonaugmented women (6,9,12,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Furthermore, specific implant characteristics such as implant volume and placement might affect the detection of breast cancer (36).…”

“…Although not statistically significant, several studies showed a tendency toward advanced breast tumors at diagnosis for women who received augmentation mammaplasty (6,(29)(30)(31)(32)(33)(34)(35). However, several other publications found little or no evidence that implant women were diagnosed at a later stage (9,12,(22)(23)(24)(25)(26)(27)(28)57). One possible explanation is the small number of breast cancer cases among augmented women cases), which may have affected study power in these studies.…”

Cancer risk among Danish women with cosmetic breast implants

“…None of these observations have been substantiated in epidemiologic studies, [11][12][13][14][15][16][17][18][19][20][21][22][23][24] and in 2000 an independent review board concluded that the available evidence does not support an association between silicone breast implants and breast carcinoma or sarcoma, multiple myeloma or lymphoma. 25 In 2001, Brinton et al reported increased incidence of and mortality from respiratory and brain cancer among 13,488 women with cosmetic breast implants compared to women in the general population and 3,936 plastic surgery controls.…”