Supporting Breast Cancer Awareness
We want our MYA community to understand the importance of breast health and awareness and how having a healthy relationship with your breasts and having a feel of them regularly could save your life!
In the UK, 1 in 7 women will be affected by breast cancer in their lifetime we want to help educate our patients and followers with the signs and symptoms and what to look out for when checking your breasts.
Look out for our monthly breast check reminders on social media
Breast Implants After Mastectomy: Risks You Need To Know
The complication rate for getting breast implants after mastectomy has been described by experts as alarmingly high and arguably unacceptable,1 even though most of the information about complications is based on studies that were paid for by companies that make breast implants or silicone.
How safe are breast implants and how many women have complications after getting reconstruction with breast implants after a mastectomy? When the Food and Drug Administration approved breast implants, they acknowledged that the complication rate is very high for all women, especially those undergoing reconstruction after a mastectomy. What the FDA did not know, however, is that early-stage breast cancer patients that undergo mastectomy and reconstruction with breast implants are 10 times as likely to commit suicide as other early-stage breast cancer mastectomy patients.
Complications from Implants
We do not know why the suicide rate is so high for mastectomy patients with breast implants, but we do know that complications are very common. For example, a study conducted by implant manufacturer Inamed found that 46% of reconstruction patients needed additional surgery within the first 2 to 3 years after getting silicone gel breast implants 2. Not surprisingly, the implant maker did not publish an article describing this high complication rate, which was more than twice as high as the 21% reported in a study funded by a company that makes silicone .1
How Breast Cancer Pain May Feel
While many types of breast pain are not cancerous, pain in only one breast may be cause for calling your doctor. Benign breast pain is often on both sides.
Breast cancer pain can be persistent and very specific, usually hurting in just one spot. It is important to remember that breast cancer can be present in your breast before it causes pain. If you have other symptoms of breast cancer, such as nipple retraction , sudden swelling of your breast, or sudden skin changes, consult your healthcare provider for a clinical breast exam.
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Preventative Measures Before Breast Surgery
I think you want to ask all the right questions as a patient. What type of implant am I having placed? What are the risks of the surgery? What are the risks of the implant?
From the physician side, its important to do a full physical exam when your patient comes in for their annual visit. That includes a full breast exam, particularly in patients who have had breast implants. If a patient notices anything suspicious or a change in the shape, size, or feel of their breast, they should bring it to the attention of their physician. And if an OB/GYN or a family practice doc has concerns, they should then have the plastic surgeon involved.
The FDA at this point recommends that either an ultrasound or an MRI can be done as a screening tool. Anyone who has symptoms should go directly to MRI. Anyone who has an implant placed, particularly a textured implant, should have a screening MRI after five or six years after the implant was placed.
Dr. Jones: Well, for many women who are making the choice about breast implants, only they will be able to balance the risks and benefits in their own bodies. But we try to give them the best information that we have and help support them with their decision. Thanks, Dr. Agarwal, and thanks for joining us on The Scope.
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How Is Inflammatory Breast Cancer Treated
Inflammatory breast cancer is generally treated first with systemic chemotherapy to help shrink the tumor, then with surgery to remove the tumor, followed by radiation therapy. This approach to treatment is called a multimodal approach. Studies have found that women with inflammatory breast cancer who are treated with a multimodal approach have better responses to therapy and longer survival. Treatments used in a multimodal approach may include those described below.
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Surgery To The Other Breast
Your other breast is likely to change as you get older or if you gain or lose weight. You may need surgery to your natural breast to get a better match.
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National Institute for Health and Care Excellence July 2018
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Early Breast Cancer: ESMO Clinical Practice GuidelinesF Cardoso and others Annals of oncology, 2019. Volume 30, Pages 1194-1220
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Breast implant-associated anaplastic large cell lymphoma : an overview of presentation and pathogenesis and guidelines for pathological diagnosis and managementJ Jones and othersHistopathology, 2019. Volume 75, Issue 6, Pages 787-796
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Association of Breast Surgery , British Association of Plastic, Reconstructive & Aesthetic Surgeons , Breast Cancer Now
Guidance for the Commissioning of Oncoplastic Breast Surgery, 2018
Fiona MacNeill and others
Improving Informed Consent: Learning About Risks Before Surgery
If youre considering breast implant surgery or any other kind of medical procedure your surgeon is supposed to make sure that you understand the risks, benefits, and alternative treatment options so you can make an informed decision. State and federal laws specify some of what is supposed to happen as part of this process, which is known as informed consent.
Ideally, informed consent involves having an open discussion with your surgeon, being able to ask questions, and receiving written information about risks thats easy to understand. This should take place before youve paid a nonrefundable deposit for the procedure. If you decide to move forward with the surgery, you sign an informed consent form, acknowledging that youve been given the information you need and that youre agreeing to the surgery.
However, not all plastic surgeons handle informed consent in the same way. Some devote more time to discussing potential risks with patients and give patients more information about risks than others. Sometimes the risk of conditions like BIA-ALCL and BII doesnt get discussed at all.
When Lory DAddario got reconstruction with Mentor textured implants in 2015, the link between breast implants and BIA-ALCL had already been identified. The FDA, the National Comprehensive Cancer Network, and the American Society of Plastic Surgeons had been publishing information about BIA-ALCL for a few years. However, DAddario says her plastic surgeon did not mention this risk.
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How Do I Spot The Symptoms
It is important to know the symptoms of breast implant associated cancer. The most common symptom is swelling of a breast caused by fluid build-up around the implant, but in some cases it may appear as a lump in the breast or armpit.
As this is a rare disease, changes in your breast are unlikely to be breast implant associated cancer. For example, swelling immediately after your breast implant surgery is normal. But you should raise all concerns with your surgeon, including the possibility of breast implant associated cancer. If the surgeon or clinic which performed your original implant operation is no longer available, you should see your GP for referral to another surgeon.
How We Got Here: A Brief History Of Breast Implant Regulation
To understand why there are still unresolved questions about the safety of breast implants nearly 60 years after they were first sold in the U.S., it helps to know a little history.
1960s-1980s: Little research and regulationWhen breast implants were first introduced in the early 1960s, there was little-to-no research on their safety and no requirement that medical devices go through an approval process. The FDA didnt have the authority to regulate medical devices until 1976, and the implants that were already on the market were grandfathered in.
Meanwhile, reports linking silicone gel-filled breast implants and autoimmune symptoms began to appear in medical literature in the 1970s and 1980s.
1980s-1990s: Lawsuits and FDA ban on silicone gel-filled implantsThousands of women won lawsuits against Dow Corning and other implant manufacturers beginning in the 1980s and throughout the 1990s, based on claims that they had developed health problems because they had silicone gel-filled breast implants.
Congress asked for a study of the safety of silicone gel-filled breast implants and, in 1999, the Institute of Medicine released a 400-page report prepared by an independent committee of scientists. The committee reviewed the existing literature and concluded that there was no clear link between silicone gel-filled implants and connective tissue disease, autoimmune disease, or cancer.
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Breast Implant Associated Anaplastic Large Cell Lymphoma
A small number of women who have implants can develop a rare type of lymphoma of the breast. You will have regular follow up appointments after surgery and your surgeon will check for any signs of lymphoma. Let your surgeon know if you notice any lump in the breast or if the breast becomes swollen. This type of lymphoma is usually easy to treat with surgical removal of the lymphoma and the implant.
There are studies to find out more about this. In one study doctors want to understand more about how changes to certain genes, proteins, and sugars could affect how BIA-ALCL develops. This may help develop new treatments for this condition in the future.
Invasive Breast Cancer Symptoms
Most breast cancers start in the ducts, or the tubes that carry milk to the nipple, or in the lobules, the little clusters of sacs where breast milk is made. Invasive breast cancer refers to breast cancer that spreads from the original site to other areas of the breast, the lymph nodes or elsewhere in the body. In these cancers that form in the ducts or lobules, invasive ductal carcinoma or invasive lobular carcinoma , the cancer spreads from the ducts or lobules to other tissue. Depending on the stage, you may notice symptoms.
Invasive breast cancer symptoms may include:
- A lump or mass in the breast
- Swelling of all or part of the breast, even if no lump is felt
- Skin irritation or dimpling
- A lump or swelling in the underarm lymph nodes
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Can You Develop Breast Implant Illness From Saline Implants
Complications from breast augmentation surgery are relatively rare, though they can occur from time to time. Choosing a highly qualified, board-certified plastic surgeon is, arguably, one of the best ways to reduce your risk of surgical complications during or after breast augmentation. In some cases, however, your selection of implant type, implant size, or implant placement may also impact your risk level. Internationally recognized board-certified plastic surgeon Dr. Sean Kelishadi and the award-winning team at SSK Plastic Surgery take extreme care to ensure each Newport Beach breast augmentation is as safe and successful as possible by utilizing the most advanced tools and techniques, as well as recommending appropriate implant selections for every patient. Learn more here about a rare complication, breast implant illness, and find out whether your choice of implant type may increase your chance of developing this condition.
What Are Breast Implants
Breast implants are gel or fluid-filled pouches inserted in the breast area. People may get breast implants for many reasons, including cosmetic enhancement or reconstruction after breast surgery.
Breast implants differ in their size, shape, filling and surface characteristics. Most implants are either round or teardrop-shaped. They may be filled with saline or with silicone gel. The surface of the implant may be smooth or rough and different implants may vary in the amount of irregularity of the texture.
Breast implants are not lifetime devices and need to be replaced after 10 to 15 years.
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Which Factors Might Put Me At A Higher Risk For Developing Bia
If youve ever had saline-filled or silicone gel-filled breast implants with a textured surface, you have a slightly higher risk of developing BIA-ALCL than if youve had only smooth-surfaced implants. It is possible that tissue expanders with a textured surface may increase the risk of developing BIA-ALCL, but information on this risk is currently limited.
Out of the cases of BIA-ALCL in which the manufacturer of the implant was known , 90.5% involved Allergan Biocell textured implants, 7.1% involved Mentor textured implants, and 1% involved Sientra textured implants. 1
Currently, there are no confirmed cases of BIA-ALCL in women who only ever had smooth implants.
Researchers have also identified certain genetic mutations that seem to increase the risk of developing BIA-ALCL . In the future, it may be possible to use a combination of genetic testing and HLA testing to determine whether an individual has an increased risk of developing BIA-ALCL.
Women: Breast Implants And Cancer Risk
In about 90% of breast cancer cases, women find a breast lumpthemselves. So, check your breasts regularly. If you have implants, payextra attention to how your new breasts look and feel.
Have breast implants? Or thinking of getting implants? You may be worried theyll make it hard for your doctor to detect and treat breast cancer.
No need for concern, says Therese Bevers, M.D., medical director of MD Andersons Cancer Prevention Center. Just take the extra precautions listed below.
Get familiar with your new breasts
In about 90% of breast cancer cases, women find a breast lump themselves. So, check your breasts regularly. Its one of the best ways to detect breast cancer early.
If you have implants, pay extra attention to how your new breasts look and feel.
Itll take a while to get used to your new breasts because theyll have a different texture. Theyll also have new folds or dimples, Bevers says.
But after you get comfortable with your new breasts, you shouldnt have any problems noticing changes.
Women with implants can sometimes even notice changes more easily than women without implants, Bevers says. Implants tend to push the natural breast tissue closer to the surface of the breast, making a lump easier to feel.
Take extra screening steps
Most women, including those with breast implants, should start annual mammograms at age 40.
Worried that flattening your breasts during the exam will damage your implants? That rarely happens, Clemens says.
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Im Considering Having My Breast Implants Removed And Going Flat What Do I Need To Know About Getting The Best Results From That Surgery
Both for cosmetic reasons and for comfort, youll probably want your plastic surgeon to make your chest as smooth and flat as possible after removing your implants. Talk with your plastic surgeon before your implant removal surgery about what he or she can do to achieve the best results. This might involve, for instance, trimming excess skin and/or moving around tissue to fill in sunken areas. You may want to show your surgeon pictures of women whove had a mastectomy with no reconstruction with results you like. Also, you might choose to look for a plastic surgeon who has produced good results for other patients who chose to go flat.
Breast Implant Associated Cancer : Information For Consumers
The TGA has published the outcomes from the breast implant review. Read the update.
On this page:What are breast implants? | What is breast implant associated cancer? | Your questions answered | Who can get breast implant associated cancer? | How is breast implant associated cancer diagnosed? | What is the treatment and prognosis for breast implant associated cancer? | How do I spot the symptoms? | What if I have implants but no symptoms at all? | Should my implants be removed even though I have no symptoms? | Can I get Medicare benefits for tests and treatment of breast implant associated cancer? | Report any problems to the TGA | Further reading
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What Is Breast Reconstruction
Many women who have a mastectomysurgery to remove an entire breast to treat or prevent breast cancerhave the option of having the shape of the removed breast rebuilt.
Women who choose to have their breasts rebuilt have several options for how it can be done. Breasts can be rebuilt using implants . They can also be rebuilt using autologous tissue . Sometimes both implants and autologous tissue are used to rebuild the breast.
Surgery to reconstruct the breasts can be done at the time of the mastectomy or it can be done after the mastectomy incisions have healed and breast cancer therapy has been completed . Delayed reconstruction can happen months or even years after the mastectomy.
In a final stage of breast reconstruction, a nipple and areola may be re-created on the reconstructed breast, if these were not preserved during the mastectomy.
Sometimes breast reconstruction surgery includes surgery on the other, or contralateral, breast so that the two breasts will match in size and shape.
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How Will Breast Reconstruction Affect My Life
Breast reconstruction may help you to feel better about your body: you may feel more normal,balanced, and feminine. It may also help you to be able to wear more kinds of clothes with convenience and comfort.Some women are afraid that if the breast cancer returns, it will be harder to detect the tumor through a reconstructed breast than through a mastectomy scar. However, there is no need to fear difficulties with cancer detection. Current evidence indicates that it is no more difficult to find and treat cancer through a reconstructed breast than it is through a mastectomy scar.If you are thinking about breast reconstruction and are interested in breastfeeding your children, you should know that you cannot breastfeed from a reconstructed breast. The parts of the breast that deliver milk are the most likely parts to develop cancer and are therefore removed during the mastectomy.Having breast reconstruction may cause you some inconvenience during the period after the surgery. It will take time to recover, and there may be additional treatments or follow-up surgeries. Depending on which kind of breast reconstruction you choose, you may need up to six months or a year to fully return to your normal life.Only you can decide whether the mental and physical benefits of having a new breast are worth the costs of having the surgery.
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