Can Breast Implants Cause Cancer? What the Studies Say

Silicone breast implants
Dr. Phillip Chang

Dr. Phillip Chang

Board Certified By The American Board of Plastic Surgeons.
Voted Top Plastic Surgeon in Loudoun, Virginia
Offices in Leesburg, Virginia.

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Recent reports have caused many women who have had breast implants or who are thinking about having breast implants to be concerned about the potential risk of breast cancer after a breast augmentation. While it’s always good to be careful, the risk is not as high as initially thought and is really only associated with textured breast implants – which Dr. Phillip Chang has never used for his patients.

Aside from from the use of textured implants, breast implants are not associated with an increased risk of breast cancer incidence or death, and these patients do not experience delayed detection or poorer post-breast cancer survival.

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What the studies say about breast implants and breast cancer

Breast augmentation using breast implants is one of the most common and popular cosmetic surgery procedures in the U.S. and around the world with some reports of up to 98% patient satisfaction rates.  It is a procedure that can add breast volume to a woman who is self conscious about having smaller breasts. It is also a popular in women who wish to restore their breast shape after having babies.

In 2011, the FDA first reported about the risk of developing a rare form of lymphoma in women who have had breast augmentation.  However, further studies have defined that the risk seems to be isolated ONLY to women who have had TEXTURED breast implants. 

Additionally, several major published studies from various countries have formally investigated the risk of breast cancer among augmentation mammaplasty patients, and none show any evidence of increased risk. In fact, most find lower than expected risk.

The findings show that there is a very small chance of developing anaplastic large cell lymphoma ( BIA-ALCL ) in patients with TEXTURED breast implants.

Textured breast implants are commonly used in women who require breast reconstruction after mastectomies or in the past by some surgeons hoping to use the implant type to prevent capsular contractures.  (For the record, I have NEVER used a textured breast implant for my patients.)

There has never been a report of the development of BIA-ALCL in a patient who has a smooth-shelled breast implant.  Further, several major published studies from various countries that have formally investigated the risk of breast cancer among breast augmentation patients have NOT shown any evidence of increased risk. In fact, most find lower than expected risk. 

Aside from from the use of textured implants, breast implants are not associated with an increased risk of breast cancer incidence or death, and these patients do not experience delayed detection or poorer post-breast cancer survival.

There are NO KNOWN CASES of breast cancer associated with SMOOTH round breast implants. All the known cases of ALCL have been in cases where a TEXTURED implant has been used. Dr. Phillip Chang has never used a textured implant for his patients.

Research on the Breast Cancer Risk and Breast Augmentation

According to Susan Komen, a prominent breast cancer advocate, neither saline nor silicone breast implants appear to increase breast cancer risk.  The organization, along with others, reviewed a meta-analysis study that combined the results from 10 studies and found no increase in breast cancer risk among women with breast implants.  In fact, many of the studies showed a lower risk of breast cancer among women with implants.

 

What does the FDA say about breast cancer and breast implants?

The FDA first identified a possible association between breast implants and the development of anaplastic large cell lymphoma (ALCL) in 2011.  According to an FDA report released in 2016, individuals with breast implants have a small risk of developing breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL. 

According to the report, BIA-ALCL is a form of non-Hodgkin’s lymphoma which is different from breast cancer. Specifically, the World Health Organization has designated it as a T-cell lymphoma. It is most often found in the scar tissue and fluid near the implant.

The FDA concluded that it’s difficult to precisely define the risks because so little information exists about the number of patients who have undergone breast augmentation in both the United States and the rest of the world. 

What is the risk of developing breast cancer BIA-ALCL in patients with textured breast implants?

Several recent publications have estimated the risk of developing BIA-ALCL in individuals with textured breast implants. According to current estimates, BIA-ALCL may develop in 1 in between 3,817 to 30,000 women with textured breast implants.

FDA recommendations to health care providers

1.  Prophylactic removal of breast implants is not necessary

2.  Patients should be informed to seek advice if they show evidence of pain, lumps, swelling, breast assymetry, or the development of a fluid collection (seroma) around the breast implant.

3.  Rule out BIA-ALCL by sending both fresh seroma fluid and representative portions of the capsule for pathology tests. 

4.  Be sure to report confirmed cases of ALCL in individuals with breast implants to the FDA through MedWatch. 

5.  Be sure to send case reports to the Plastic Surgery Foundation’s PROFILE registry. 

Click here to learn more about the FDA’s recommendations to health care providers, particularly about reporting breast cancer. 

FDA recommendations to patients

1.  Take the time to learn about the different types of breast implants before undergoing an augmentation procedure. 

2.  Keep in mind BIA-ALCL appears to develop more frequently in individuals with textured implants than in people with smooth-surfaced implants. The cost and benefits of textured vs smooth implants is a great topic to bring up with your health care provider!  

3.  Expect swelling and pain after immediately following your surgery. But if you’ve recovered and you notice your breasts look or feel different (i.e. you feel swelling or pain where the implant is located), you should talk to your health care provider about the possibility of BIA-ALCL.

Click here to learn more about the FDA’s recommendations to patients following breast augmentation surgery, especially if you are concerned about cancer.  

Invitation

For those wondering whether breast augmentation might be the best cosmetic solution for you, we invite you to simply come in for a complimentary consultation with Dr. Chang or one of the cosmetic laser and injection nurses to explore whether you would make a good candidate. To find out more whether Aesthetica can help you, contact us online or at 703-729-5553 to arrange an appointment. Dr. Phillip Chang is a board-certified plastic surgeon in Northern Virginia near Leesburg, Virginia and an expert in a wide variety of cosmetic treatments.

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FAQs About Breast Implants and Breast Cancer

No, the only reported cases of breast cancer post-surgery is when textured breast implants are used. No recent studies have connect smooth implants and breast cancer. 

Not exactly.  It is a technically a cancer in the breast but not really a breast cancer . The distinction is that the cells that form the cancer are not breast cells.  BIA-ALCL is a type of non-Hodgkins lymphoma; it is a cancer of the immune system.

I would argue that in most cases textured implants are unnecessary to achieving your desired aesthetic. Textured implants are largely used for anatomic or tear-drop shaped implants to prevent them from rotating in the breast pocket. But, tear-drop shaped implants are the wrong look for most women. 

No, according to Susan Koman. In fact, the organization found that many studies show a LOWER risk of breast cancer among women with implants. 

 Not at this time. According to FDA representatives, they don’t meet the legal standard for banning at this time. 

Absolutely contact your health care provider. Some swelling and pain is to be expected after surgery. But if your breast look or feel different than they should, or if you feel any lumps or bumps not normal to your breast tissue, talk to your health care provider. 

Educate yourself and contact us. We would be happy to help you weigh the pros and cons of all the different breast implant options. We want to make these decisions as easy for you as possible! 

References

1. Hoshaw SJ, Klein PJ, Clark BD, Cook RR, Perkins LL. Breast implants and cancer: causation, delayed detection, and survival. Plast Reconstr Surg. 107(6):1393-407, 2001.

2.  Brinton LA, Brown SL, Colton T, et al. Characteristics of a population of women with breast implants compared with women seeking other types of plastic surgery. Plast Reconstr Surg. 105(3):919-27, 2000.  

3.  U.S. Food and Drug Administration. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239995.htm, 2017.

4.   Noels EC, Lapid O, Lindeman JH, Bastiaannet E. Breast implants and the risk of breast cancer: a meta-analysis of cohort studies. Aesthet Surg J. 35(1):55-62, 2015.

5.  Lipworth L, Tarone RE, Friis S, et al. Cancer among Scandinavian women with cosmetic breast implants: a pooled long-term follow-up study. Int J Cancer. 124(2):490-3, 2009.

6.  Deapen DM, Hirsch EM, Brody GS. Cancer risk among Los Angeles women with cosmetic breast implants. Plast Reconstr Surg. 119(7):1987-92, 2007. 

7.  Leberfinger AN, Behar BJ, Williams NC, et al. Breast implant-associated anaplastic large cell lymphoma: a systematic review. JAMA Surg. 152(12):1161-1168, 2017.

8.  Pan SY, Lavigne E, Holowaty EJ, et al. Canadian breast implant cohort: extended follow-up of cancer incidence. Int J Cancer. 131(7):E1148-57, 2012.

9.  McLaughlin JK, Lipworth L, Fryzek JP, Ye W, Tarone RE, Nyren O. Long-term cancer risk among Swedish women with cosmetic breast implants: an update of a nationwide study. J Natl Cancer Inst. 19;98(8):557-60, 2006.

10.  Bryant H, Brasher P. Breast implants and breast cancer–reanalysis of a linkage study. N Engl J Med. 332(23):1535-9, 1995.

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