Breast cancer and silicone breast implants

Abstract

Since 1962, breast implants made of a silicone elastomer envelope filled with either silicone or saline have been used by an estimated l-2 million women in the United States alone. Given that women in the United States have a lifetime risk of breast cancer of approximately 1 l%, and the concerns which have been expressed about the risks associated with the use of silicone breast implants, we reviewed the medical literature to thoroughly evaluate the risks of breast cancer to users of these implants.Our review of case reports and series, surveys of plastic surgeons, case-control and cohort studies did not show any evidence that women who use silicone breast implants are at any increased risk of breast cancer. Neither of two large cohort studies found any increased risk of breast cancer among the 11 676 women in one study [1] or the 3111 women in the other study [2] with breast implants. In both studies, approximately 85% of the women used silicone gel implants. One of these studies [1] found that breast implant users were at a reduced risk of breast cancer! Even if allowances are made for underreporting of breast cancer cases among * Corresponding author, Tel.: +I 619 2805587.breast implant users, neither study provides any evidence of an increased risk of breast cancer.There remains the question of whether the use of silicone implants per se delays the early detection of breast cancer. Issues related to the detection of breast cancer among women with augmented breasts are whether: (1) the frequency of a missed diagnosis of breast cancer is different for women with or without augmented breasts; and (2) the presence of breast implants significantly delays the diagnosis of breast cancer. The first issue has not been adequately evaluated. However, if there was a higher frequency of missed breast cancer diagnoses among breast implant users, one would then expect that this group of women would present with more advanced breast cancers. The few studies [3-51 that have evaluated the characteristics of the cancers among women with and without breast implants have not found that the cancers of the implant group are any different from those of other women. In addition, there is no evidence that patients with breast cancers have their cancers diagnosed at a later stage than patients without breast implants [5,6].For women with silicone breast implants, the available data do not show an increased risk of 0020-7292/94/507.00 0 1994 International Federation of Gynecology and Obstetrics SSDI 0020-7292(94)02181-W

Invasive micropapillary carcinomas arising 42 years after augmentation mammoplasty: A case report and literature review

“…First, the liquid silicone used for injection has been shown to occasionally contain additives which may have sometimes been of a non-medical grade. Second, the physiological response to liquid silicone may be different from that of vulcanized silicones, such as silicone gels [ 1 ]. Furthermore, Felix et al reported the tumorigenicity of silicone gels in the mouse plasmacytoma system [ 18 ].…”

“…Although breast cancer after augmentation mammoplasty has been reported and the causal relationships between foreign bodies in the breast and carcinogenesis have been reviewed, so far no definitive consensus opinion has been obtained [ 1 - 11 ]. This report describes a unique case of multiple invasive micropapillary carcinomas (IMPCs) of the breast arising 42 years after augmentation mammoplasty by the injection of liquid silicone.…”

Pregnancy, lactation and the use of silicone breast implants

“…In a recent review, no evidence was found to associate the use of silicone breast implants with either an increased risk of breast cancer or an increased risk of a more advanced stage of cancer at the time of cancer diagnosis, compared to women not using breast implants [6].…”

Breast Implants and Breast Cancer Screening

“…Another retrospective case‐controlled study found that the average stage of cancer detected in women with implants was less advanced than the stage of cancer in patients without implants 39 . However, interpretation of these results is clouded by the small sample sizes, known referral bias, and design flaws such as the failure to obtain preaugmentation baseline mammograms 1,23,49 …”

“…Nearly 2 million women in the United States have undergone augmentation mammoplasty, one of the most frequent plastic surgery procedures 1 . In 2000, approximately 300,000 women in the United States had this surgery performed 2 .…”