Breast implants have been a popular choice for both cosmetic enhancement and reconstruction post mastectomy aka breast removal surgery often due to cancer. However, concerns about their safety, particularly regarding cancer risk remain prevalent. In this blog, we’ll address the most frequently asked questions about silicone implants, breast cancer risk, breast implant cancer treatment, and more.
Types of breast implants
Breast implants are primarily of two types – saline filled and silicone implants.
Saline filled implants are made of outer silicone shell filled with sterile saline( salt water) while silicone implants have a silicone shell filled with silicone gel. The outer shell of the implants is manufactured from polysiloxane silicone rubber. The implants also vary in profile, volume, surface which can be either smooth or textured and thickness.
Smooth implants were introduced in 1961. In the late 1980s textured implants were developed to address issues like implant movement and capsular contracture. The rough, sandpaper-like surface of textured implants allowed surrounding tissue to grow into the implant surface, anchoring it in place and hence reducing the risk of implant movement or rotation. When the textured implants were linked to Breast anaplastic large cell lymphoma microtextured implants were introduced in early 2000s.
Do Breast Implants Increase Breast Cancer Risk?
Breast implants don’t increase the risk of typical breast cancer which arises in the breast tissue compared to women without implants. Though Implants can make it harder to detect tumors during routine screening mammography, hence FDA suggests separate screening protocols for females with implants. In fact, some studies have shown that the rates of breast cancer in women with implants are similar to or even slightly lower than those in women without implants owing to the demographics and health behaviors of women who typically receive implants.
What is Breast Implant-Associated Cancer: BIA-ALCL ?
While breast implants do not increase the risk of traditional breast cancer, they have been linked to a rare type of cancer called Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) which is a type of non-Hodgkin’s lymphoma (cancer of the immune system).It develops in the scar tissue and fluid surrounding the implant. The incidence reported by various studies is variable ranging from 1in 355 to 1 in 50000 but is commonly associated with textured implants. No study has been carried out specifically for the Indian population as of date.
Symptoms of BIA-ALCL include persistent swelling or enlargement of the breast, lump near the implant, redness, pain, or rash, skin changes such as dimpling or puckering and change in breast shape or firmness. These can develop months or even years after the implant surgery. If in case any symptoms are noticed immediate evaluation is advised with your plastic surgeon.
Treatment:
Most cases are treated successfully if caught early. Primary Treatment includes complete surgical removal of the implant and surrounding scar tissue (capsule). This is often curative if the disease is localized. In advanced Cases if the cancer has spread, additional treatments such as chemotherapy or radiation may be needed.
Monitoring and Prevention
Women are advised to follow up regularly with their plastic surgeon after the surgery. MRI screening has been advised by the FDA with first screening 5-6 years after surgery and next screening 2-3 yearly in asymptomatic women. This does not replace regular mammograms for breast cancer screening. Self breast examination should be done regularly for any changes, regardless of whether they have implants. MRI or ultrasound can help monitor implant integrity and detect complications. In case of any symptoms, prompt medical advice should be taken.
Do old Breast Implants cause cancer?
Breast implants are not lifetime devices and have an average lifespan of 10-15 years . They will likely need to be exchanged as the longer you have breast implants , higher the chances of experiencing complications like implant rupture ,leakage and capsular contracture(hardening of the tissue around the implant) .It was also observed that long term exposure to textured implants was found to increase the risk of this rare lymphoma while no such cases were reported with the smooth implants.
What else should you keep in mind before getting the surgery?
Although knowledge is vital and easily accessible on many platforms, it is crucial that you speak with a board certified plastic surgeon about your objectives and concerns. It is crucial that the surgeon performing your surgery is qualified and that the hospital is accredited and prepared to manage any emergencies that may arise. After talking about all the potential short- and long term issues and how to handle them, as well as the various implants, you should make an informed decision regarding your surgery. Every patient receives a device card that contains the implant’s size, style, and serial number as well as a unique device identification number (UDI) for future reference that has all the information you could possibly require.
Conclusion
To conclude breast implants don’t increase the risk of traditional breast cancer but they have been linked to a rare lymphoma called BIA-ALCL, especially with older and textured implants. Awareness of symptoms and regular medical check-ups are key to early detection and effective treatment. If you’re considering implants or already have them, talk openly with your plastic surgeon about the risks and benefits. With proper care and monitoring, you can make empowered decisions about your body and well-being.
Keywords: silicone implants, breast cancer risk, breast implant cancer treatment, is breast cancer more common with implants, breast implant cancer symptoms, old breast implants and cancer, breast implant complications.
Doren EL, Miranda RN, Selber JC, et al. U.S. epidemiology of breast implant-associated anaplastic large cell lymphoma. Plast Reconstr Surg 2017; 139(5):1042–1050. [DOI] [PubMed] [Google Scholar]
Cordeiro PG, Ghione P, Ni A, Hu Q, Ganesan N, Galasso N, Dogan A, Horwitz SM. Risk of breast implant associated anaplastic large cell lymphoma (BIA-ALCL) in a cohort of 3546 women prospectively followed long term after reconstruction with textured breast implants. J Plast Reconstr Aesthet Surg. 2020 May;73(5):841-846. doi: 10.1016/j.bjps.2019.11.064. Epub 2020 Jan 20. PMID: 32008941; PMCID: PMC7247945.
Lynch EB, DeCoster RC, Vyas KS, Rinker BD, Yang M, Vasconez HC, Clemens MW. Current risk of breast implant-associated anaplastic large cell lymphoma: a systematic review of epidemiological studies. Ann Breast Surg 2021;5:30
Disclaimer : The opinions here are personal views of the authors. IAAPS is not responsible. All members may not have the same scientific view point
