Abstract
Background:It is thought that implants interfere with breast cancer diagnosis and that cancers in women who have had breast augmentation carry a worse prognosis.
Methods:A prospective breast cancer database was reviewed, comparing augmented and nonaugmented patients for details of histology, palpability, tumor size, nodal status, mammographic status, receptor status, nuclear grade, stage, and outcome.
Results:Ninety-nine cancers in augmented women and 2857 cancers in nonaugmented women were identified. Among these women, mammography was normal in 43% of those who had had augmentation and in 5% of those who had not. Augmented women were more likely to have palpable cancers (83% vs. 59%) and nodal involvement (48% vs. 36%), and less likely to have ductal carcinoma in situ (DCIS) (18% vs. 28%). When comparing only women younger than 50, the differences in invasiveness and nodal status lost significance. Cancers diagnosed in the 1990s were more likely to be nonpalpable and noninvasive than those diagnosed in the 1980s. This trend was more pronounced in the augmented population.
Conclusions:Augmented patients were more likely to have palpable cancers, although the overall stage and outcome were similar to those of nonaugmented women. Although there have been significant improvements in our ability to diagnose early breast cancer over the past two decades, mammography continues to be suboptimal in augmented women.
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REFERENCES
Berkel H, Birdsell DC, Jenkins H. Breast augmentation: a risk factor for breast cancer. N Engl J Med 1982; 326: 1649–53.
Bryant H, Brasher P. Breast implants and breast cancer- reanalysis of a linkage study. N Engl J Med 1995; 332: 1535–9.
Kern KA, Flannery JT, Kuehn PG. Carcinogenic potential of silicone breast implants: a Connecticut statewide study. Plast Reconstr Surg 1997; 100: 737–47.
Deapen DM, Pike MC, Casagrande JT, Brody GS. The relationship between breast cancer and augmentation mammoplasty: an epidemiologic study. Plast Reconstr Surg 1986; 77: 361.
Deapen DM, Bernstein L, Brody GS. Are breast implants anticarcinogenic? A 14-year follow-up of the Los Angeles study. Plast Reconstr Surg 1997; 99: 1346–53.
Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics 2000. CA Cancer J Clin 2000; 50: 7–33.
Liebman A, Kruse B. Breast cancer: mammographic and sonographic findings after augmentation mammoplasty. Radiology 1990; 174: 195–8.
Silverstein MJ, Handel N, Gamagami P, et al. Breast cancer diagnosis and prognosis in women following augmentation with silicone gel-filled prostheses. Eur J Cancer 1992; 28: 635–40.
Schirber S, Thomas WO, Finley JM, et al. Breast cancer after mammary augmentation. South Med J 1993; 86: 263–8.
Carlson GW, Curley SA, Martin JE, et al. The detection of breast cancer after augmentation mammoplasty. Plast Reconstr Surg 1993; 91: 837–40.
Clark CPIII, Peters GN, O’Brien KM. Cancer in the augmented breast. Cancer 1993; 72: 2170–4.
Cahan AC, Ashikari R, Pressman P, et al. Breast cancer after breast augmentation with silicone implants. Ann Surg Oncol 1995; 2: 121–5.
Birdsell DC, Jenkins H, Berkel H. Breast cancer diagnosis and survival in women with and without breast implants. Plast Reconstr Surg 1993; 92: 795–800.
Fajardo LL, Harvey JA, McAleese KA, et al. Breast cancer diagnosis in women with sub-glandular silicone gel-filled augmentation implants. Radiology 1995; 194: 859–62.
HayesHJr, Vandergrift J, Diner W. Mammography and breast implants. Plast Reconstr Surg 1993; 92: 209–16.
Eklund G, Busby R, Miller S, Job J. Improved imaging of the augmented breast. Am J Roentgenol 1988; 151: 469–73.
Silverstein MJ, Handel N, Gamagami P, et al. Mammographic measurements before and after augmentation mammoplasty. Plast Reconstr Surg 1990; 86: 1126–30.
Grace GT, Roberts C, Cohen IK. The role of mammography in detecting breast cancer in augmented breasts. Ann Plast Surg 1990; 25: 119–23.
Liebman AJ, Kruse BD. Imaging of breast cancer after augmentation mammoplasty. Ann Plast Surg 1993; 30: 111–15.
Dixon W, Massey F. Introduction to Statistical Analysis. 3rd ed. New York: McGraw-Hill, 1969.
Clayton D, Hills M. Statistical Models in Epidemiology. Oxford: Oxford University Press, 1993.
Kalbfleisch J, Prentice R. The Statistical Analysis of Failure Time Data. New York: John Wiley and Sons, 1980
Dodd G. American Cancer Society Guidelines for the Early Detection of Breast Cancer: An Overview. Cancer 1992; 69(7 Suppl): 1885–7.
Leitch A, Dodd GD, Constanza M, Linver M, Pressman P, McGinnis L, Smith RA. American Cancer Society Guidelines for the Early Detection of Breast Cancer: Update 1997. CA Cancer J Clin 1997; 47: 150–3.
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Skinner, K.A., Silberman, H., Dougherty, W. et al. Breast Cancer After Augmentation Mammoplasty. Ann Surg Oncol 8, 138–144 (2001). https://doi.org/10.1007/s10434-001-0138-x
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DOI: https://doi.org/10.1007/s10434-001-0138-x