If you’ve ever thought of getting breast implants, maybe you’ve weighed the pluses and minuses. In the “pros” category: look better in clothes; get a self-esteem boost. The cons: the cost (high), the risk of complications (fairly high), the chances you’ll get stuck with a leaky implant (low). Or maybe you’ve already had a breast augmentation; about 29 percent of American women who opted for the surgery in 2012 were between 20 and 29, according to the American Society of Plastic Surgeons.
Perhaps one thing you didn’t consider, especially if you’re young and not at an increased risk of breast cancer, is whether the implants might make it difficult to see a tumor during a mammogram. (Most women don’t start getting annual mammograms until around age 40.) Breast cancer has a cure rate of nearly 93 percent when it’s diagnosed at its earliest stage, according to the American Cancer Society. But when it’s caught later, like any other type of cancer, the outlook is not nearly so bright (at its latest stage, the survival rate from breast cancer is just 15 percent). So being able to find a tumor that might be cancerous early is essential.
Young women are also more likely to have dense breasts, which can hurt the accuracy of a mammogram (this is why health experts recommend that younger women get a digital mammogram, versus one done by X-ray, since the former is better at detecting cancer in dense breasts).
A new BMJ study looked at whether having cosmetic breast implants—filled with saline (saltwater) or silicone—made a difference in when a woman’s breast cancer was caught by mammography, and also examined the survival rate of women who had breast cancer and implants, as compared to breast cancer patients who didn’t have cosmetic augmentation.
The researchers, led by epidemiologist Eric Lavigne of the Universite Laval, in Quebec, Canada, reviewed a large body of information to see if there was any relationship between having the implants and being diagnosed with breast cancer at a stage when the cancer had already spread, and also if breast implants affected a breast cancer patient’s chances of dying of the disease. (It’s important to note that studies to date do not show that implants in any way cause breast cancer. The Food & Drug Administration does call attention to a possible link between implants and anaplastic trial lymphoma, a rare type of cancer, but there is little evidence for this right now, says Dr. Lavigne.)
In total, the research reviewed included over 28,000 women and found that those with implants had later-stage tumors when they were diagnosed with breast cancer. "The risk of dying from breast cancer following the diagnosis of such disease is 38 percent higher among those with implants compared to women without implants," explains Dr. Lavigne. "It's important to mention that their risk is following the diagnosis of breast cancer, which would possibly be because of the advanced stage at diagnosis."
Why weren’t the women diagnosed sooner? It may be because the implants obscured visualization on mammograms, making it hard or impossible for a radiologist to see the breast tissue well. Doing a mammogram in a woman with implants is also not easy (you can’t compress the breast in the mammography machine the same way you would an implant-less breast), which means less tissue gets examined. The researchers also noted that “capsular contracture”—a build-up of scar tissue around the implant, which happens in 15 percent to 20 percent of patients—can impair what a radiologist or technician can see as well. The placement of the implants (particularly under the glands in the breast, versus under the muscle) can also make a clear reading difficult. Radiologists do use techniques to compensate for these limitations, but in most cases mammography in a woman with implants is not ideal for detecting breast cancer, especially at the earliest stages.
There is some good news for women under 40 (or so), though. “Women at a younger age are less likely to develop breast cancer because of their reduced risks associated with age,” Dr. Lavigne told TakePart. “However, they should still be aware of the issue of breast cancer detection in the presence of breast implants because, as they get older, they will have to be screened for breast cancer and this is when it may become problematic to detect a tumor at an earlier stage.” Lavigne also stresses that this new research didn’t include a large sample of studies, among other limitations, so more trials are definitely needed.
If you’re considering getting implants, it’s essential to understand all the risks. A new report from the American Society of Plastic Surgeons (ASPS) says that 98 percent of 225 women surveyed who got a breast augmentation were happy with the results, and that the procedure remains the most popular type of plastic surgery in the U.S., with about 286,000 augmentations taking place in 2012, according to ASPS. “The most important thing is to talk about this with a physician and discuss the possible long-term implications of cosmetic breast implants,” advises Dr. Lavigne. “Women should be able to have clear information before making a decision about undertaking cosmetic breast augmentation.” (On the con side, the Food and Drug Administration’s “Breast Implants: Local Complications and Adverse Outcomes” booklet [PDF] lists 30 different types of possible complications from breast augmentation.)
If you do opt for the implants, or have them already, don’t miss your mammograms, as imperfect as they may be, says Lavigne: “I would advise premenopausal women with breast implants to continue to be screened regularly for breast cancer.” And be sure to talk to your doctor about your own risk of breast cancer, which can be dramatically affected by your family history of the disease.
Do you have implants or have you considered them? Are you worried about breast cancer and whether the implants might make it harder to see a tumor?