Breast Cancer After Augmentation Mammoplasty

Escandón, Joseph M.; Silberman, Howard; Dougherty, William; Gamagami, Parvis; Waisman, James; Sposto, Richard; Silverstein, Melvin J.

doi:10.1007/s10434-001-0138-x

Cited by 60 publications

(27 citation statements)

References 26 publications

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“…The study concluded that the presence of minimal capsular contracture resulted in a 30% reduction in visualized breast tissue, whereas moderate or severe capsular contracture led to a 50% decrease. In support of these findings, Skinner et al (16) found that augmented women were more likely to present with palpable cancers rather than mammographic abnormalities, as compared to nonaugmented women (83% versus 59%), although the overall stage and outcome were similar in both groups.…”

Section: Discussionmentioning

confidence: 86%

“…Consistent with the above referenced studies, our results may indeed represent a reduced sensitivity of mammography, as influenced by a reduction in visualized breast tissue, the inability of radiologists to identify tumors in the presence of an implant, or the rate of tumor growth between screening examinations (18). In addition, the increased proportion of palpated tumors in our cohort may also be attributed to decreased breast volume in the presence of an underlying firm implant to palpate against (16,17,19,20). This, in combination with a potential for increased breast/body awareness in augmented women, may further enhance the utility of the breast examination (16,17,19,20).…”

Section: Discussionmentioning

confidence: 89%

“…In addition, the increased proportion of palpated tumors in our cohort may also be attributed to decreased breast volume in the presence of an underlying firm implant to palpate against (16,17,19,20). This, in combination with a potential for increased breast/body awareness in augmented women, may further enhance the utility of the breast examination (16,17,19,20). Although our findings confirm those of other studies, whether they represent an increased sensitivity of SBE/CBE, a corresponding decrease in sensitivity of mammography, or a combination of both, remains a topic of future study.…”

Section: Discussionmentioning

confidence: 89%

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Diagnosis, Treatment, and Management of Breast Cancer in Previously Augmented Women

et al. 2006

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Augmentation mammaplasty is rapidly becoming one of the most frequently performed cosmetic surgeries. However, as the augmented patient population ages, major concerns associated with the screening, diagnosis and treatment of breast cancer are being realized. Although current evidence convincingly indicates that breast implants do not play a role in inducing localized or systemic disease, particularly breast cancer, recent studies have shown implants not only reduce the sensitivity of mammography, but interfere with mammographic detection, possibly leading to delayed breast cancer diagnosis. In addition, the risk for local recurrence, as well as unfavorable cosmetic results, breast fibrosis, and capsular contracture following radiation therapy as part of breast-conserving therapy in previously augmented patients are of great concern. Given the overall lack of treatment consensus, paucity of literature, and increasing number of augmented breast cancer patients, we provide a retrospective review of the diagnosis, treatment, and follow-up of 12 augmented patients from 1998 to 2004 who developed breast cancer. Eight of 12 augmented patients presented with a palpable mass on physical examination, which prompted further mammographic evaluation. Abnormalities in the remaining four individuals were detected on routine mammographic screening. Pathology staging results were available for all 12 patients. Breast-conserving therapy was used to treat six patients and adequate negative pathologic margins were obtained in all patients. The remaining six patients were treated with mastectomy due to multifocal disease, inadequate margins, or proximity to the implant capsule. Thus far, one patient has had local recurrence and one patient has had distant recurrence after initial surgery. No evidence of local or systemic recurrence, infection, contracture, poor cosmetic outcome, or other complications has been detected in the remaining 10 patients as of the most recent follow-up. Based on this small cohort of augmented women, the presence of implants led to an increased proportion of palpable tumors, in spite of routine screening mammography. Consistent with other studies, although our results suggest a tendency toward delayed diagnosis in augmented women relative to age-matched controls, this did not appear to influence the overall prognosis.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 89%

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Diagnosis, Treatment, and Management of Breast Cancer in Previously Augmented Women

et al. 2006

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“…A formal evaluation of whether implants delay the detection of breast cancer among women with breast implants can be made by comparing their stage distribution at diagnosis to a suitable comparison group. While a few studies have performed such evaluations, their findings have been mixed with some reporting that women with breast augmentation may be more likely to be diagnosed with advanced cancers5, 18–21 while others have reported no such difference 4, 8, 22–28. Most of these studies have been severely limited by a small number of incident breast cancers.…”

mentioning

confidence: 99%

The influence of cosmetic breast augmentation on the stage distribution and prognosis of women subsequently diagnosed with breast cancer

Xie

Brisson

Holowaty

et al. 2010

Intl Journal of Cancer

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This study aimed to determine whether cosmetic breast implants impair the early detection of breast cancer, and adversely influence survival. This analysis derives from a cohort of 24,558 women who received bilateral cosmetic breast implants, and 15,893 women who underwent other plastic surgery procedures at the same practices in Ontario and Quebec, Canada, between 1974 and 1989. Incident cancers and vital status through 1997 were determined by record linkage to the Canadian Cancer Registry and Canadian Mortality Database. Analyses are based on a total of 182 and 202 incident cases of breast cancer identified among the implant and control groups, respectively. Contingency table analyses were performed to test for differences in the stage distribution of breast cancers between the 2 groups. Potential differences in survival were evaluated using the Kaplan-Meier estimates and Cox proportional hazards models. Women who received breast implants were more likely to have advanced stage breast carcinoma relative to the other plastic surgery patients (crude and adjusted ps 0.01). No statistically significant differences in distributions between the implant and control patients were found for age at diagnosis, tumor size, histological type, period of diagnosis or length of follow-up. The delayed diagnosis in augmented women did not appear to influence the overall prognosis. Breast cancer-specific survival was similar in both groups (hazard ratio 5 1.06; 95% confidence interval 5 0.65-1.74). In conclusion, this study suggests that breast implants delay the detection of breast cancer, but there was no statistically significant difference in survival between the breast implant and other plastic surgery groups.

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“…22,23,[32][33][34] Others have shown that women with implants had larger primary tumors, more positive axillary nodes, or a lower percentage of palpable tumors visible on mammography than comparison groups of women without breast implants. 17,[35][36][37] Because of the relatively young age of the women in these studies, screening mammography may not have been performed routinely in this subgroup of patients.…”

Section: Breast Cancer Stage At the Time Of Detectionmentioning

confidence: 96%

Breast Cancer in the Previously Augmented Breast

McCarthy

Pusic

Disa

et al. 2007

Plastic and Reconstructive Surgery

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Breast cancer in a previously augmented breast raises questions regarding cancer detection and staging, surgical and adjuvant treatment options, reconstructive outcomes, management of the contralateral breast, and continued breast cancer surveillance. This article explores the oncologic and reconstructive issues relevant to women desiring cosmetic breast implants and women with breast cancer who have undergone prior cosmetic breast augmentation.

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Breast Cancer After Augmentation Mammoplasty

Cited by 60 publications

References 26 publications

Diagnosis, Treatment, and Management of Breast Cancer in Previously Augmented Women

Diagnosis, Treatment, and Management of Breast Cancer in Previously Augmented Women

The influence of cosmetic breast augmentation on the stage distribution and prognosis of women subsequently diagnosed with breast cancer

Breast Cancer in the Previously Augmented Breast

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