Old Breast Implants And Cancer Risks
There is a link between old breast implants and a cancer called breast implant-associated large cell lymphoma, or BIA-ALCL. BIA-ALCL develops in the scar tissue between the breasts and the implants. The longer the breast implants are in, the higher the risk of BIA-ALCL development. There are steps women can take to stay safe.
By Step Treatment Of Bia
Things To Think About Before Getting Implants
Most women will do well with implants. But there are some important factors to keep in mind if you are thinking about having implants to reconstruct the breast and/or to make the other breast match the reconstructed one:
- You may need more surgery to remove and/or replace your implant later. In fact, up to half of implants used for breast reconstruction have to be removed, modified, or replaced within 10 years.
- You might have problems with breast implants. They can break or cause infection or pain. Scar tissue may form around the implant , which can make the breast harden or change shape, so that it no longer looks or feels like it did just after surgery. Most of these problems can be fixed with surgery, but others might not.
- Breast MRIs may be needed every few years to make sure silicone gel implants have not broken. Your health insurance might not cover this.
- Routine mammograms to check your remaining breast for cancer could be harder if you have a breast implant there you may need more x-rays of the breast, and the compression may be more uncomfortable.
- An implant in the remaining breast could affect your ability to breastfeed, either by reducing the amount of milk or stopping your body from making milk.
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Corrective Surgery For Breast Implant Rupture
When a saline or silicone gel-filled implant has ruptured, the implant should be surgically removed. In some cases, your plastic surgeon will also remove the capsule of scar tissue surrounding the implant or just cut open the capsule by making small incisions.
If you have implants in both breasts, your plastic surgeon will in most cases remove both of them, even if only one has ruptured. If you have a silicone implant that has leaked beyond the capsule, your plastic surgeon will remove the silicone that has leaked out.
Usually if youve decided that you want new implants, your surgeon can insert them during the same surgery. In some cases, your surgeon may recommend that you switch to a different type of implant.
Another option may be to have your breast reconstructed with a flap of tissue taken from another place on your body rather than getting new implants. With an autologous reconstruction, you wont have any risk of a rupture in the future or of the other complications that can develop with implants. However, autologous reconstruction involves a more complex, time-consuming surgery and a longer recovery time. Learn more about autologous reconstruction.
References
Augmentation Patient Are Not At A Greater Risk Of Developing Breast Cancer
This concern came out of studies in rats back in the 1940’s where foreign objects implanted in them increased their risk of developing sarcomas. However, this was never found to be the case in humans, in fact, several studies have both refuted this fact and also found no association between breast implants and breast cancer.
However, breast implant associated anaplastic large cell lymphoma has recently been in the spotlight and is definitely a condition associated with breast implants as the name suggests. This is, however, NOT breast cancer. To find out more about BIA-ALCL, read our blog on ALCL
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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.
Screening More Effective For Natural Breasts
Breast cancer can be detected either through screening with a mammogram or when women experience symptoms and seek medical attention in between screenings. Both causes of diagnosis were included in the study.
Among women with implants, 174 received breast cancer diagnoses, corresponding to 1.7 per cent.
Among those without implants, 30 746 women had breast cancer. This corresponds to 4 per cent, more than twice the incidence of those with implants.
Screening detected 62 percent of breast cancer cases in this group.
Among the women with implants, only 46 per cent of breast cancer cases were detected by screening.
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Could My Implants Compromise My Mammogram
According to stopcancerfund.org, breast implants can interfere with the detection of breast cancer by obscuring the mammography image of a tumor and potentially delaying the diagnosis of breast cancer.
The American Cancer Society warns that the X-rays used in mammograms cannot go through silicone or saline implants well enough to show the underlying breast tissue where your radiologist is looking for signs of cancer. This means that the part of the breast tissue covered by the implant wont be seen on the mammogram.
Your plastic surgeon has the option of putting your implant in front of your pectoralis muscle or behind it. Imaging a breast with an implant in front of the pectoralis muscle can be more complicated because the implant needs to be moved out of the way to get a good view of all the breast tissue during the exam.
Thats when the experience of your mammography technologist comes into play. According to Dr. Walters. If you have a good tech and if the implant is behind the pectoralis muscle and you move it out of the way, you can see most of the breast tissue very well.
TIP: When you call to schedule your appointment, make sure to mention you have breast implants so your technologist will know in advance.
What Factors Can Affect The Timing Of Breast Reconstruction
One factor that can affect the timing of breast reconstruction is whether a woman will need radiation therapy. Radiation therapy can sometimes cause wound healing problems or infections in reconstructed breasts, so some women may prefer to delay reconstruction until after radiation therapy is completed. However, because of improvements in surgical and radiation techniques, immediate reconstruction with an implant is usually still an option for women who will need radiation therapy. Autologous tissue breast reconstruction is usually reserved for after radiation therapy, so that the breast and chest wall tissue damaged by radiation can be replaced with healthy tissue from elsewhere in the body.
Another factor is the type of breast cancer. Women with inflammatory breast cancer usually require more extensive skin removal. This can make immediate reconstruction more challenging, so it may be recommended that reconstruction be delayed until after completion of adjuvant therapy.
Even if a woman is a candidate for immediate reconstruction, she may choose delayed reconstruction. For instance, some women prefer not to consider what type of reconstruction to have until after they have recovered from their mastectomy and subsequent adjuvant treatment. Women who delay reconstruction can use external breast prostheses, or breast forms, to give the appearance of breasts.
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Possible Causes Of A Lump With Breast Augmentation
If you can feel a lump in your breast implant, it may be related to a fold or crease in the actual implant shell. This will be more common in women who have a contracture or a firmness to their implants. This firmness around the implant can cause it to change shape and form a buckle that might feel like a mass on the implant. Pain can be associated with implant lumps because they can be sharp and cause inflammation.
The first concern about a mass is the possibility of cancer. This is one of the leading causes of death in the female population and will affect an astounding 1 out of every 8 women in their lifetime. As your age increases, so does your risk of cancer. Most breast cancers are found in women older than fifty, and they are rarely found in patients younger than 25. Regardless of your age, there are steps you should take.
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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What You Think Is A Lump Might Be Your Implantbut Get It Checked Anyway
Sometimes women with implants think they detect a lump in their breast, but what theyre actually feeling is the implant.
Saline implants, in particular, can bulge like a partially filled water balloon, Dr. Baker points out. But he urges any woman who feels a lump to get checked out. Dont assume its the implant and ignore it!
A woman who has implants is not at increased risk of developing breast cancer, he says, but it does not prevent her from getting breast cancer.
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.
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Have You Developed Symptoms
The most common symptoms are unexplained breast enlargement, asymmetry, fluid buildup or a lump in the breast or armpit, but may be rarely more subtle such as overlying skin rash, hardening of the breast. Women who develop these symptoms should see their physician to be evaluated with a physical exam and further testing.
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.
If you are considering breast implants, read our page that covers things you should know before undergoing the procedure.
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Mammograms For Women With Breast Implants
If you have breast implants, you should still get regular screening mammograms as recommended.
Its important to tell the technologist you have implants before your mammogram is started. In fact, its best to mention this when you make the appointment to have your mammogram done. This way you can find out if the facility has experience doing mammograms in women with breast implants.
You should be aware that it might be hard for the doctor to see certain parts of your breast. The x-rays used in mammograms cannot go through silicone or saline implants well enough to show the breast tissue that is in line with them on the mammogram. This means that part of the breast tissue can be hard to see on a mammogram.
To help the doctor see as much breast tissue as possible, women with implants have 4 extra pictures done , as well as the 4 standard pictures taken during a screening mammogram. In these extra pictures, called implant displacement views, the implant is pushed back against the chest wall and the breast is pulled forward over it and then compressed. This allows better imaging of the front part of each breast.
Implant displacement views are harder to do and can be uncomfortable if a lot of scar tissue has formed around the implants. ID views are easier if the implants were placed underneath the chest muscles.
Very rarely, the mammogram process can rupture an implant. This is another important reason to make sure the mammography facility knows you have implants.
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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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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