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Breast Cancer & Implants: Surgery Options

Breast-Conserving Surgery an Option for Women With Breast Implants and Breast Cancer
By
WebMD Health News
Reviewed by Louise Chang, MD

May 2, 2008 (New York) -- There's reassuring news for women with breast implants who develop breast cancer.

Despite earlier concerns, many can be effectively treated with breast-conserving treatment rather than a more disfiguring mastectomy to remove the entire affected breast, researchers say.

Breast-conserving treatment consists of surgical removal of the cancerous area of the breast, followed by radiation to kill any lingering tumor cells.

Breast augmentation is the most common cosmetic procedure in the U.S., with 329,000 implants performed in 2006.

"As these women age, their rate of breast cancer can be expected to rise as it does for all women. But relatively little research has focused on how implants affect breast cancer treatment," says Barbara Pockaj, MD, a breast surgeon at the Mayo Clinic in Rochester, Minn.

Pockaj presented the findings at the American Society of Breast Surgeons Ninth Annual Meeting.

Implants Don't Affect Recurrence Rates

The researchers examined the management of breast cancer in 71 women who got breast implants between 1995 and 2006.  About half underwent mastectomy, and the rest received breast-conserving treatment.

The recommendation that a woman get a mastectomy was based primarily on whether she had a large tumor or several tumors throughout the breast, the same criteria used for women without implants.

The rate of local recurrence -- cancer returning in the same breast -- was about 8% in women who underwent mastectomy and those who underwent breast-conserving therapy.

That's also in the same range as the local recurrence rate for women without implants who undergo breast-conserving therapy, Kristin Brill, MD, a breast surgeon at Kimmel Cancer Center in Philadelphia, tells WebMD. She was not involved with the work.

Other Findings

Among other findings:

Sentinel node biopsy was accurate in women with implants who had the biopsy, regardless of what treatment they received. Sentinel lymph node biopsy involves removing just a few key lymph nodes first, rather than the usual 10 to 20, to check for cancer spread.

"There were a lot of concerns that implants would affect the accuracy of the test, but that was not the case," Pockaj tells WebMD.

There was an increased rate of capsular contraction in women with implants who had breast-conserving treatment: 31% vs. 12% of those who had a mastectomy.

Capsular contraction is one of the most common problems associated with implants. It occurs when scar tissue forms around the implant, and it can cause hardening of the breast tissue, rippling in the skin of the breast, and changes in the shape of the breast. Surgery is sometimes needed to remove the scar tissue or replace the implant.

Pockaj says that taken together, the findings show "breast-conserving treatment is a viable option for women with implants. Women are often told they have to have a mastectomy, but this study shows they don't."

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