Cancer among Scandinavian women with cosmetic breast implants: A pooled long‐term follow‐up study

Abstract

No increased risks of specific types of cancer following breast implantation have been consistently reported, but data on risk beyond 15 years are limited. We have pooled the results of 2 nationwide cohort studies of 3,486 Swedish and 2,736 Danish women who underwent cosmetic breast implantation between 1965 and 1993. Cancer incidence through 2002 was ascertained through nationwide cancer registries. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated to compare cancer incidence among women with implants with women in the general population. Mean duration of follow up was 16.6 years (range 0.1-37.8 years). Over 50% of women were followed for 15 years or more after breast implantation and 13.3% for at least 25 years. There was a reduced incidence of breast cancer (SIR 5 0.73; 95% CI 0.58-0.90), whereas lung cancer was above expectation (SIR 5 1.64; 95% CI 1.10-2.36). The increased risk of lung cancer is expected due to the high prevalence of smoking among the women with implants in our study. With respect to other site-specific cancers, no significantly increased or decreased SIR was observed. This study, which includes women followed for almost 4 decades, represents the longest follow up of women with cosmetic breast implants to date. The results provide no evidence of an association between breast implants and any type of cancer. ' 2008 Wiley-Liss, Inc.Key words: breast implants; cancer incidence; epidemiology; cohort study Based on the results of numerous epidemiologic studies and independent scientific reviews, 1-6 there is no evidence for an association between cosmetic breast implants and the occurrence of breast cancer. In fact, women with cosmetic breast implants consistently have a lower than average risk for breast cancer. Concerns about other types of cancer have been raised by reports of silicone-induced plasmacytomas in genetically susceptible mice, 7 and by anecdotal reports of lymphoma and multiple myeloma in women with cosmetic breast implants. [8][9][10][11] However, no increased risks of specific types of cancer have been consistently reported in epidemiologic studies.We pooled the results of 2 nationwide cohort studies of women with cosmetic breast implants in Sweden 12 and Denmark. 13 This analysis based on 6,222 women with over 100,000 person-years of follow up, including women followed for more than 37 years after implantation, represents the longest follow up of women with cosmetic breast implants published to date, thus allowing us to present risk estimates for numerous additional cancer sites with too few cases to be included in the original reports. Material and methods Breast implant cohortsDetails about study cohorts and methods have been presented elsewhere. 12,13 Briefly, the studies were conducted in Sweden and Denmark using essentially complete nationwide population-and health care registers, including Hospitalization Registers, Cancer Registers, Death Registers, Migration Registers, and Population Registers. Unique personal identifiers assigned ...

Evaluation of the Biocompatibility of Silicone Gel Implants - Histomorphometric Study

“…Despite frequent local complications and adverse outcomes, the benefits and risks of implants are sufficiently well understood for patients to make informed decisions about their use (16, 17). The longer a human has silicone gel-filled implants, the more likely he is to experience local complications or adverse outcomes.…”

The Levels of Evidence and Their Role in Evidence-Based Medicine

“…Because of these results, several large retrospective cohort studies from the United States, Canada, Denmark, Sweden and Finland were conducted. 28–32 The level of evidence for a retrospective cohort is 2. All of these studies had many years of follow-up for a large number of patients.…”

Narcissism, Perfectionism, and Interest in Cosmetic Surgery

“…[1][2][3][4] Patients with a diagnosis of implant-related ALCL have had implants that were either ruptured or intact, filled either with saline or with silicone gel, and placed for either reconstructive or cosmetic purposes; these varying circumstances have not appeared to make any difference. 5,6 Although large observational epidemiological studies in North American and Scandinavian women have disproved significant associations with breast cancer or other specific cancer sites or with autoimmune disease, [11][12][13][14][15][16][17] currently, clinical and histological findings of two major reviews 5,6 speak in favor of an association between breast implants and ALK-1-negative ALCL, which presumably is an indolent form of this group of non-Hodgkin's lymphoma that is completely distinct from the systemic disease with a clinical behavior more similar to primary cutaneous ALCL than to the systemic counterpart. Thus, several authors agree that implant-related ALCL should be recognized as a separate category in the World Health Organization's classification, with its own diagnosis and treatment.…”