From the Guidelines
Breast augmentation does not increase the risk of developing breast cancer, as evidenced by large-scale studies that have followed women with implants for many years. Women with breast implants have the same risk of breast cancer as women without implants, according to the most recent and highest quality study available 1. However, it's crucial to note that breast implants can make mammography screening more challenging due to the potential for implants to obscure some breast tissue. For this reason, women with breast implants should inform their mammography technicians about their implants so that additional displacement views can be taken to visualize as much breast tissue as possible.
Some key points to consider regarding breast implants and cancer risk include:
- The FDA has identified a possible association between breast implants and anaplastic large cell lymphoma (ALCL), a rare T-cell lymphoma, with most reported cases associated with textured implants 1.
- The risk of breast implant-associated ALCL is considered rare, and the disease arises around the implant, not in the breast tissue itself 1.
- Regular breast cancer screening remains essential for all women, including those with implants, as early detection is critical for effective treatment and improved outcomes.
- The biological reason implants don't increase cancer risk is that they don't interact with breast tissue in a way that promotes cellular mutations or abnormal growth patterns that lead to cancer development, with the implant generally isolated from the breast tissue by a fibrous capsule that forms around it.
In terms of specific recommendations for women considering breast augmentation, it is essential to discuss the risks and benefits of breast implants with a healthcare provider, including the potential for implant rupture, capsular contracture, and the rare risk of ALCL. Women should also be informed about the importance of regular follow-up, including ultrasound or MRI screenings, to monitor the condition of their implants and overall breast health 1.
From the Research
Breast Augmentation and Cancer Risk
- Breast augmentation is not associated with an increased risk of breast cancer, as stated in studies 2, 3
- However, implants may interfere with the detection of breast cancer, thereby delaying cancer diagnosis in women with augmentation 2
- The sensitivity of screening mammography is lower in women with breast augmentation compared to those without, but the specificity is slightly higher 2
- Tumors in women with breast augmentation are of similar stage, size, estrogen-receptor status, and nodal status, but tend to be lower grade 2
Types of Implants and Cancer Risk
- Textured silicone implants are associated with a rare lymphoma subtype, breast implant-associated anaplastic large cell lymphoma (BIA ALCL) 4
- Saline and silicone breast implants may predispose patients to BIA ALCL, which presents as a peri-implant fluid collection ± mass 4
- There is no significant difference in breast cancer risk between women with saline-filled implants and those with silicone-filled implants 5, 3
Screening and Detection
- Special mammographic views are indicated to enhance accuracy in women with breast implants 6
- Patients with silicone breast implants should undergo routine screening for implant rupture with magnetic resonance imaging or ultrasonography 6
- Women with unilateral breast swelling should be evaluated with ultrasonography for an effusion that might indicate BIA ALCL 6