Current Trends in the Oncologic and Surgical Managements of Breast Cancer in Women with Implants: Incidence, Diagnosis, and Treatment
- 892 Downloads
Breast augmentation is the most common cosmetic surgery in the United States, and thousands of augmented patients develop breast cancer each year. The possible effects of implants on cancer incidence, diagnosis, and treatment usually generate a disarming confusion. The present paper represents an update of the more recent oncologic and surgical strategies, aiming to support plastic and general surgeons in such challenging aspects. Several aspects of breast cancer management in augmented women are investigated, including (1) risk estimation and cancer characteristics, stage at diagnosis, and prognosis; (2) cancer diagnosis with clinical examination, mammography, ultrasound, and magnetic resonance imaging; (3) cancer treatment including breast conservation, intraoperative radiotherapy, sentinel node biopsy and mastectomy, and reconstruction. A brief resume of recommendations and conclusions is suggested, elucidating correct trends in the oncologic management of augmented patients and refusing well-established misconceptions: (1) breast augmentation does not increase the risk of breast cancer incidence, and it does not influence the prognosis; (2) possible risks exist in cancer detection due to technical difficulties; (3) sentinel lymph node detection is feasible; (4) intraoperative radiotherapy represents a good chance for conserving treatment; (5) immediate reconstruction with submuscular–subfascial implants is the most common procedure after mastectomy, and biological substitutes could support this procedure. Breast clinicians should be alerted because of high expectations of this subgroup of patients, accustomed to emphasize the aesthetic result.
Level of Evidence V
This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
KeywordsBreast augmentation Breast cancer Implants and cancer Women with implant Intraoperative radiotherapy
None of the authors received any funding for this work from any of the following organizations: the National Institutes of Health (NIH); the Wellcome Trust; the Howard Hughes Medical Institute (HHMI); and other(s).
Compliance with Ethical Standards
Conflict of interest
None of the authors has any commercial associations or financial interests to disclose.
This study is in compliance with the principles of the Helsinki Declaration. The paper has never been presented before.
- 1.American Society of Plastic Surgeons (2013) 2013 Cosmetic plastic surgery statistics. Available at: http://www.plasticsurgery.org/Documents/news-resources/statistics/2013
- 2.Associazione Italiana Chirurgia Plastica Estetica (2013) 2013 data. http://www.aicpe.org/news-chirurghi/comunicato-stampa/2014