Breast Implants and Cancer Risks
At Montecito Plastic Surgery, it is always our priority to make sure our patients are informed about and comfortable with their decision to move forward with surgery. That’s why we’ve pulled together this page Breast Implants and Cancer Risk – a topic that can often generate conflicting information. As an informed patient, we want you to have the facts.
Some quick facts:
- Breast cancer survival is the same for patients with and without breast implants¹
- BREAST IMPLANT ASSOCIATED ANAPLASTIC LARGE CELL LYMPHOMA (BIA-ALCL) is very rare and associated with abnormal capsules and fluid collections almost exclusively following placement of textured breast implants²
- Dr. Lowenstein uses smooth implants over 98% of the time
- BIA-ALCL is EXTRAORDINARILY rarely if ever associated smooth shelled implants that are most often used at Montecito Plastic Surgery²
- If you do have textured implants the risk of getting BIA-ALCL is 1 in 30,303 (33 per 1,000,000 patients)²
SOME DETAILS AND OTHER INFORMATION
Breast implants are one of the most frequent plastic procedures performed throughout the world. One of the questions that we hear often is if breast implants are related to breast cancer, and if patients with breast implants can be at higher risk for cancer. Patients also ask if breast implants make it more difficult to detect cancer. Recently, there has also been a lot of sensational reports about the risk of Breast Implant Associated Anaplastic Large Cell Lymphoma (ALCL). Patients should be well informed about all risks as well as benefits of having breast implants, and since the benefits of breast implants are pretty obvious, let’s talk about the cancer risks associated with breast implants.
BREAST CANCER (cancer of the breast tissue, lobular breast cancer and ductal breast cancer)
There has been a lot of studies performed over many years that show that breast implants do not cause breast cancer such as lobular or ductal breast cancer, the cancers of the actual breast tissue. The next question to ask is if a breast implant makes it harder to detect breast cancer. The answer to that question seems to be highly related to who you ask. There are breast experts that believe that because the breast tissue is stretched over the breast implant and spread out more in breast implant patients, that it can be easier to feel a smaller breast cancer nodule in patients with breast implants as opposed to women without implants. This theory would indicate that it is easier to detect breast cancer at an early stage in women who have had breast augmentation with breast implants. Other breast doctors feel that breast cancers that can form near the edges of the implant, or rarely behind the breast implant, can be harder to detect when patients have breast implants vs. those women without breast implants. One thing that both of these groups of breast experts can agree on is the conclusion of the multitude of studies that involve breast implants and breast cancer…
THERE DOES NOT SEEM TO BE ANY DIFFERENCE IN SURVIVAL OF BREAST CANCER PATIENTS WHO HAVE HAD BREAST IMPLANTS VS THOSE WHO HAVE NOT HAD BREAST IMPLANTS.¹
What this means is that while many patients may be able to detect cancer sooner with the implant in place, and others may find that there is somewhat of a delay in the diagnosis, the cancers seem to be caught in a similar fashion to patients without breast implants, and the rates of cure and survival don’t change for patients with breast implants when compared to those without implants.
What this also means is that patients with breast implants should continue their normal screening for breast cancer with mammograms or ultrasounds as your primary care doctor or OBGYN instructs you, since when it comes to the survival rates for breast cancer, breast implant patients are no different than women who don’t have breast implants.
BREAST IMPLANT ASSOCIATED ANAPLASTIC LARGE CELL LYMPHOMA (BIA-ALCL)
Breast implant associated anaplastic large cell lymphoma is NOT breast cancer. It is a rare cancer of the T-cells which are part of the immune system, and it is a type of non-Hodgkin’s lymphoma. ALCL is a type of cancer that can occur in many different parts of the body, but recently has been found in a relatively few number of patients that have had breast implants, usually implants that have a textured surface (the kind Dr. Lowenstein hardly ever uses) . In breast implant patients, ALCL often occurs many years after the breast augmentation has been performed, and is usually associated with a rare complication called a seroma. A seroma is a fluid collection that can but rarely forms around the breast implant. In a small portion of patients who have this rare fluid collection, ALCL has been found in the overlying scar tissue, called the capsule, rather than in the breast tissue itself. It is important to remember that ALCL is quite rare, and that the vast majority of cases have been found associated with a specific type of breast implant- one with a textured surface.² In our practice, Dr. Lowenstein uses smooth breast implants instead of textured implants about 98% of the time.
Can we put some numbers on it… what is the risk of a patient with breast implants getting ALCL? Well this is a tough question for two reasons. The number of reported cases of BIA-ALCL are very low, and as of March 2017, there seems to be 359 breast implants that have had associated ALCL that have been discovered EVER IN THE WORLD. The other problematic number is how many breast implants have been placed? That is a VERY difficult number because most foreign countries don’t report the number of breast implants placed each year. The American Society of Plastic Surgeons estimates that in 2015, there were 279,000 breast implant procedures performed, and since most women get two breast implants at a time, we can assume that there were 558,000 (279,000 x 2) breast implants placed in the Unites States alone in 2015. And so if we realize that breast implants were first sold in the US in the 1960’s, the number of breast implants in women in the world today is thought to be nearly 10 million.
According to a study published two months ago, 3.3 out of every 1,000,000 women with textured breast implants will develop BIA-ALCL.² In other words, 1 in every 30,303 women with textured breast implants will develop the disease over their lifetime. And it is important here to remember that there have been nine deaths from BIA-ALCL. Because there is a low rate of death from BIA-ALCL, the mortality risk is a fraction of 1 in 30,303.
According to the Insurance Information Institute (III), here are some interesting odds of some other things happening in your lifetime….
- Dying from heart disease… 1 in 599
- Dying from any accident… 1 in 2469
- Dying from pneumonia… 1 in 6622
According to the same III numbers, if you were born in 2013, your lifetime risks of the following are:
- Dying from a motor vehicle accident… 1 in 113
- Being killed by a firearm… 1 in 358
- Drowning while in or falling into swimming pool… 1 in 6,162
1. Breast implants and breast cancer: a review of incidence, detection, mortality, and survival. Deapen D. Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):70S-80S.
2. United States Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Doren EL1, Miranda RN, Selber JC, Garvey PB, Liu J, Medeiros LJ, Butler CE, Clemens MW. Plast Reconstr Surg. 2017 Jan 20.