Breast Augmentation and Cancer

By Jerome Edelstein, MD

ARE WOMEN WITH IMPLANTS MORE LIKELY TO DEVELOP BREAST CANCER?Many women may believe that there is a link between breast cancer and implants. Fortunately, this isn’t true: no evidence has been found that implants are capable of causing or contributing to the development of breast cancer. Statistics measuring breast cancer rates among women with and without implants have found no significant difference in the occurrence of the disease between the two groups, leading doctors to the conclusion that no such link exists.

A secondary concern regarding the ability of implants to interfere with early breast cancer detection is also unfounded. Statistics have determined that there is no major difference in the advancement (or stage) of breast cancer in women who have implants versus those who don’t.SCREENING FOR BREAST CANCER WITH IMPLANTSRoughly one in eight women will develop breast cancer in their lifetime (National Cancer Institute). Because of this, all women should be diligent in screening themselves, regularly performing self-examinations and attending breast examinations. A family history of breast cancer, especially when first-degree relatives have suffered from the disease before menopause, is also a large risk factor and must be considered.

While implants do not have a connection with the development of cancer it’s important to note that they may complicate mammography screenings. Whether the implant is situated above or below the chest muscles, women with implants must notify their physicians and mammography technicians that they have received breast augmentation. Modern mammography clinics use sophisticated technology that is able to properly image breasts with implants, but technicians must be made aware that they are performing a mammogram where an implant is involved. In some cases they may choose to couple traditional screening technology with MRI or ultrasound radiography in order to properly assess the breast and implant. Women who have experienced capsular contracture should also let physicians and technicians know.

Some mammography scans may cause implant rupture or deflation, especially if the technician is not warned you have implants.ANAPLASTIC LARGE CELL LYMPHOMA AND BREAST IMPLANTSAnaplastic Large Cell Lymphoma (or ALCL) affects one out of every 500,000 women each year (National Cancer Institute) and is considered a rare form of lymphoma. Incidents of breast lymphoma are even less common and are only diagnosed in three out of every 100,000,000 women per year. ALCL, unlike breast cancer, has been found to develop more commonly in women with breast implants than women without (even though these occurrences are still rare). While this may sound alarming, these cases of ALCL actually affect the breast implant capsule and not the breast tissue itself. Because of this, capsulectomy (removal of the breast implant capsule) works to completely cure ALCL affecting women with implants.
PUTTING ANAPLASTIC LARGE CELL LYMPHOMA RISKS IN PERSPECTIVEA 2011 FDA study, conducted over 13 years, recorded information on 60 women with breast implants who suffered from ALCL. The study leveraged its sample group of ALCL affected women with 5 to 10 million women across the world with breast implants. Even while using the most cautious math, this research found that only 4.6 women with breast implants would be diagnosed with ALCL per year, a rate only slightly higher than the 3 women without implants diagnosed each year.

Simply put, the risk of a woman with breast implants developing breast ALCL is slightly lower than the risk of being hit by lightning. One woman out of one million women with breast implants will be diagnosed with ALCL per year while two women from this group will be struck by lightning during the same period of time (as per National Oceanic and Atmospheric Administration statistics).

Another example of the small risk associated with ALCL and breast augmentation is the relationship between alcohol consumption and breast cancer. As mentioned above, data from the National Cancer Institute shows that approximately one in eight women will be diagnosed with breast cancer in their lifetime. With a life expectancy of 80.8 years (an average determined by the U.S. Census Bureau) the statistical risk of breast cancer is set at 1:650 per year (1539:1,000,000 women each year). This can be weighed against the studies that have established a link between increased breast cancer risks and alcohol consumption. A report (Boyle & Bofetta) that analyzed 38 studies determined that women who drank an average of one alcoholic drink per day developed breast cancer at a relative risk rate of 1.1.

When held up against the risk of women with breast implants developing ALCL (1:1,000,000/year), women who drink alcohol are far more likely to develop breast cancer (154:1,000,000/year).