Breast implants and cancer - what are the facts?
WITH the recent news of the potential link between cancer and breast implants still in our minds, Seniors News asked Queensland breast physician Dr Deborah Pfeiffer to explain the facts.
What are breast implants?
They are synthetic medical devices that are surgically placed to increase the size, shape or fullness of the breast for cosmetic reasons, or to replace breast tissue that has been surgically removed for treatment or prevention of breast cancer by partial or total mastectomy.
Older implants, also called breast prostheses, are silicone pouches filled with either saline or liquid silicone. Most recent implants are made of solid silicone gel within a silicone shell. The outer shell may be smooth or textured, depending upon the manufacturer.
Breast implants and cancer
It's important to know there is no association between having breast implants and subsequent breast cancer.
Women with implants have the same risk of developing breast cancer as those without, apart from those who have implants following total mastectomy.
The lifetime risk of breast cancer for most women is about one-in-eight for women living to age 85.
Recently it has been recognised that there is a rare type of non-breast cancer called anaplastic large cell lymphoma (ALCL) that is associated with only some types of textured implants. The risk of developing ALCL with implants is estimated at between one-in-1000 to one-in-10,000 women who have implants.
Women with breast implants require regular breast screening and clinical breast examination, but the method of screening may differ from women without implants. Conventional 2-dimensional screening mammography may be less effective with implants in place and some women require supplemental screening with 3D mammography, ultrasound, and/or MRI.
Women who develop breast cancer with breast implants in place may or may not require removal of the implant on the affected side, depending up on the size and location of the cancer and the condition of the implant.
If the implant is removed, it may be replaced with a new implant, usually upon completion of the treatment for the cancer.
Women who develop the rare form of implant-associated lymphoma must have both implants removed and not replaced.
Do I need to do anything?
Most women with breast implants that aren't causing them any symptoms or problems don't need to worry.
All women, with and without implants, should be breast-aware and regularly self-examine for any changes.
A screening mammogram should be performed every two years at least to age 75 and women should enquire about the state of their implants on mammography. Unfortunately, this information is not routinely provided in the BreastScreen Australia program and women may need to ask about this at the time of booking their mammogram.
Women who have any concerns about their breasts or implants should consult their GP who will recommend appropriate imaging and referral to a breast specialist if indicated.
Many women may have a small amount of silicone leakage from one or both implants that may not cause any concern. However, any new lump or swelling, pain, or rash in the breast or armpit, should be fully investigated.
If you have breast implants with no symptoms but would like them removed, there may be a Medicare benefit for this procedure depending upon the type of implant. Medicare benefits are payable for the investigation and treatment of non-cosmetic implant problems. Cosmetic problems alone are not rebateable.
Before making a decision
If you are considering breast implants for cosmetic reasons, it's important that you be fully informed of the relative risks and financial costs of having the procedure and of the type of implant that your surgeon recommends.
You need to be aware of the possible complications over time, and of the additional breast cancer screening that may be required.
In summary, if you currently have or are contemplating having breast implants, ensure you talk with your GP and a check on your breasts before you make any decisions.
More information is at tga.gov.au/hubs/breast-implants.