Recent headlines and studies are reporting an increased risk of patients with textured breast implants developing a rare form of cancer called breast implant-associated large-cell lymphoma. Disturbingly, a new study is now showing a link between textured implants placed after a mastectomy and an increased risk of breast cancer recurrence.
The study conducted by the Samsung Medical Center followed 650 women who underwent a total mastectomy and immediate implant-based breast reconstruction using both smooth (39.9%) and textured (60.1%) implants. By the four year follow up period, 28 women (4.1%) were diagnosed with a type of breast cancer recurrence. Of those, 23 received the textured implant and 5 received a smooth implant. Interestingly, the negative association had no relation to the stage of cancer or ER (estrogen receptor) status.
“We believe that this study raises an urgent need for further well-designed investigations, which either may refute the findings of this study with more solid evidence and reassure patients or may produce similar results and lead to increased caution in breast cancer surveillance,” the authors of the study stated in their findings published in the October issue of JAMA Surgery.
Although these findings are concerning, there are several study limitations which indicate further studies are needed for us to have a more definitive understanding between textured implants and breast cancer recurrences. The sample size of patients in this study is considered small, and the 4-year follow-up period was “inadequate… especially for ER-positive breast cancer”, as mentioned by the editors themselves.
So, what does this mean for patients?
At PRMA, we firmly believe patients should be fully informed of all their breast reconstruction options before undergoing surgery. This includes discussing the risks and benefits associated with each reconstruction option…including the option of NOT undergoing reconstruction.
For patients seeking implants, it is important to discuss the type of implant used with your surgeon. Implants can have either textured or smooth surfaces, and can be filled with saline or silicone gel.
Although implants are a great option for some patients, autologous reconstruction options (like the DIEP flap) are a safe, natural alternative for patients seeking reconstruction after mastectomy. Unlike implants, autologous reconstruction options (referred to as “flaps”) have not been found to increase the risk of breast cancer recurrence or any other rare cancers. Several studies also show that flaps are associated with higher patient reported satisfaction and fewer complications following radiation treatments.
There are a variety of flap-based reconstruction options. Tissue can be transplanted from the lower abdominal region, the inner or outer thighs, the buttock, and the back.
What if you currently have textured implants?
First and foremost, remember that this is NOT an emergency. However, we encourage patients with textured implants who are concerned to schedule a follow up appointment with their surgeon to review their individual situation. We also recommend patients become familiar with the signs and symptoms associated with BI-ALCL. For patients who simply want to remove their textured implants, that is an option too. Further surgery to replace the implant with a safer implant or your own tissue is possible any time, as is the option to simply remove the implant and go flat.
Author: Dr. Minas Chrysopoulo and Courtney Floyd
For patients seeking implant options, it is important to discuss the type of implant used with your surgeon. Implants can range from textured to smooth and can be filled with saline or gel/silicone.
Although implants are a great option for some patients, autologous reconstruction options (like the DIEP flap) are a safe-natural implant-alternative option for patients seeking reconstruction after mastectomy.
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Great information, I can personally support this as have great success with DIEP following implant removal.
January 15,2021
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Colleen Febach
Great information, I can personally support this as have great success with DIEP following implant removal.
PRMA Plastic Surgery
Thank you for sharing your experience Colleen!