Breast Implants and Cancer
- The FDA warned that more people have been found to have squamous cell carcinoma (a form of skin cancer) and various lymphomas (cancer of the immune system) in the capsule [scar tissue] around their breast implants.
- In explaining this new warning, one of our experts said the FDA received reports of 19 total patients affected by this disease, which is “similar to the prior warnings.”
- Though this is an important risk to know about, our experts say people do not need to run out an remove their implants. They should continue regular screenings and appointments with their doctor.
- However, if they are concerned, patients can certainly have their implants removed.
- The FDA continues to urge anyone considering breast implants or those who may already have them to learn about the risks and benefits of implants, be aware that cases of skin cancer and various lymphomas in the breast implant scar tissue have been reported, and monitor your breasts or implants for changes.
“The FDA is aware of 19 cases of SCC in the capsule around the breast implant from published literature,” the March 2023 FDA update states, noting the information includes the FDA's review of medical literature and reports.
Read MoreSpeaking with SurvivorNet about this report, Dr. Sarah P. Cate, Mount Sinai Health System Director for the Breast Surgery Quality Program and Special Surveillance and Breast Program, said, “This new warning includes an updated number of cases of SCC, which is now 19 total patients who have been affected by this disease. Otherwise, it is similar to the prior warnings.”
“SCC associated with implants is extremely, extremely rare. However, patients do not do well once diagnosed with this type of SCC,” Dr. Cate warned. “It is different than the lymphoma associated with implants, which is usually curable with removal of the implant. As it is rare, implants are routinely being offered to patients.”
The FDA continues to urge anyone considering breast implants or those who may already have them to learn about the risks and benefits of implants, be aware that cases of SCC and various lymphomas (other than BIA-ALCL) in the breast implant scar tissue have been reported, and monitor your breasts or implants for changes.
Breast Implants and Cancer Risk
As Dr. Cate explained, a person with breast implants is very unlikely to see squamous cell carcinoma or lymphoma in the scar tissue of the implants, but it is possible.
Last year, Mount Sinai's Dr. Cate and Dr. Jordan Jacobs, a plastic and reconstructive surgeon, gave some insight into breast implants and their link to cancer.
"There is little detail regarding the severity of the cancers and the types of implants to which they are linked," the two told SurvivorNet in a joint statement. "The fact that the cancers were found in the implant capsules is certainly concerning and requires further investigation."
"It is not possible to conclude from this preliminary data that the cancers are definitively linked to breast implants."
Silicone Breast Implants Are A Safe Option You Just Have To Monitor Them Carefully
Dr. Cate and Dr. Jacobs also mentioned that the FDA required the placement of black box warnings on breast implant packaging and implemented an implant checklist for patients to look over and sign prior to surgery in October 2021.
They also said that anaplastic large cell lymphoma, a rare form of non-Hodgkin lymphoma, has been "associated with textured implants for several years."
"We do not use these at Mount Sinai," the doctors explained. "This is a separate issue though, and almost all the implicated implants have been taken off the market."
To put last year’s published FDA findings in perspective, Dr. Cate and Dr. Jacobs attempted to illustrate "just how small the incidence is of these newly reported cancers."
"There are approximately 400,000 women who have implants placed per year for either reconstructive or cosmetic purposes," they told SurvivorNet. "If you consider a 10-year follow-up period, the incidence of these cancers is approximately 0.00075%. In other words, 1 in every 133,000 women."
What Is Squamous Cell Carcinoma (SCC)?
Squamous cell carcinoma is a common type of skin cancer that is usually simple to treat if caught early on. It’s a form of cancer that develops in the squamous cells, that make up the skin’s middle and outer layers.
According to the Mayo Clinic, this type of cancer is most often not life-threatening, however, it can be aggressive. If squamous cell carcinoma is left untreated, the skin cancer can grow or spread to other areas of your body.
Most squamous cell carcinomas of the skin are derived from ultraviolet (UV) radiation exposure, either from tanning beds/lamps or the sun. Reducing the amount of UV light your skin is exposed to can help decrease your risk of squamous cell carcinoma of the skin and other types of skin cancer.
If this type of cancer has spread past the initial tumor site, as per Harvard Health, radiation therapy can also be effective if the cancer is located in one area. Although, if the cancer has metastasized in a more widespread manner, chemotherapy does work well in fighting it.
Squamous Cell Carcinoma (SCC) Symptoms
Symptoms of squamous cell carcinoma of the skin are normally found on sun-exposed skin, in areas such as your scalp, the backs of your hands, your ears, or your lips. However, it can also be found in other areas of your body, like inside your mouth, under your feet, and on your genitals.
The Mayo Clinic lists possible signs and symptoms of squamous cell carcinoma of the skin as:
- A firm, red nodule
- A flat sore with a scaly crust
- A new sore or raised area on an old scar or ulcer
- A rough, scaly patch on your lip that may evolve into an open sore
- A red sore or rough patch inside your mouth
- A red, raised patch or wartlike sore on or in the anus or on your genitals
Additionally, some risk factors that may increase your risk of getting this type of cancer are having fair skin, blonde or red hair, freckles, spending a lot of time in the sun without using sunblock, the use of tanning beds, prior sunburns, history of precancerous skin lesions or skin cancer, a weakened immune system, or a rare genetic disorder.
Should I Get My Breast Implants Removed?
If you have breast implants or are planning to get this type of reconstructive surgery in the future, you may now be curious as to whether you should have your implants removed or not follow through with the procedure.
Dr. Cate, who is also the Assistant Professor of Surgery at the Icahn School of Medicine at Mount Sinai, told SurvivorNet that if you already have implants, you don’t have to run out and immediately remove your implants. You should continue recommended screenings and follow-up appointments with your plastic surgeon.
Dr. Andrea Pusic On Breast Reconstruction Options After A Mastectomy
“ASPS (the American Plastic Surgery Society) issues periodic updates regarding implants,” Dr. Cate said in a recent interview. “They have their own registry of patients with these types of cancer. Patients can request their implants to be removed if they are concerned. They can also check to see if they have textured implants, which are associated with lymphoma.”
When to Be Concerned About Your Implants
Dr. Cate and Dr. Jacobs urge anyone with breast implants to keep an eye out for the following symptoms and contact a physician if one of the following is noticed:
- Breast swelling
- Pain
- Redness
- Tightening
- A change in the shape of their breasts
If you end up needing an evaluation of your implants, you will undergo a physical exam and imaging studies "to evaluate the implant shell integrity, determine if there is fluid around the implant and visualize the implant capsule." Most breast radiologists can examine fluid on whether abnormal cells are present.
"Surgical management includes removal of the implant and the surrounding capsule, which is sent to pathology to rule out atypical cells and/or cancer," Dr. Cate and Dr. Jacobs said in an earlier interview with SurvivorNet.
Learning About Breast Implants
Implant reconstruction surgery can be done with two different kinds of implants: saline, which is a sterile saltwater-filled implant, and silicone.
Saline implants require less monitoring since it will be obvious if there is a leak. Silicone implants feel and look better, Dr Andrea Pusic, Chief of Plastic and Reconstructive Surgery at Brigham and Women's Hospital, told SurvivorNet in an earlier interview.
She explained that silicone implants require a higher level of surveillance with MRI. If the silicone does leak, it poses no health risks but it will have to be replaced.
The American Society of Plastic Surgeons says silicone gel implants are “the most widely studied medical device in the history of medical devices.” Also, the Food and Drug Administration (FDA) says implantswhether saline or siliconeare not lifetime devices.
Comparing Saline vs. Silicone Implants
Meanwhile, textured breast implants have previously been linked to cancer, and in rare instances, other implants can leak or rupture. However, experts have told SurvivorNet that the significant majority of women “do really well” with their breast implants and do not experience complications.
Back in 2019, the U.S. Food and Drug Administration (FDA) urged doctors, plastic surgeons, and breast implant manufacturers to increase detailed safety warnings for patients about the risks that come along with breast implants.
According to Dr. Pusic, the 2019 guidelines shouldn't be understood as implants are unsafe.
"The vast majority of women who have breast implant surgery, whether it be for cosmetic reasons or for reconstruction after breast cancer surgery, do really well with their implants," Dr. Pusic told SurvivorNet. But complications are possible rare cases, and the FDA wants women to be aware of the risks.
"The FDA is really trying to help make sure that women know as much information as we [providers] do about the risks of breast implants and that they're able to process that and make a good decision themselves," Dr. Pusic said, noting she hopes people don’t misinterpret the FDA’s prior guidance to mean that breast implants overall “aren't safe.”
That same year, a (less common) type of breast implant the textured kind was discovered to be connected to a rare type of cancer called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). The cancer link resulted in the manufacturing company that makes the textured implants, Allergen, Inc., recalling the products across the globe.
Related: Recall for Textured Breast Implants What Women Should Know About the Cancer Risk
It’s important to note that most women who get breast implants do not get the textured kind that’s linked to cancer. The more popular option is “smooth” implants, which are usually filled with either silicone or saline. Unlike textured implants, smooth ones have not been linked to cancer. However, smooth implants have previously had potential complications reported in the past, such as joint pain, muscle aches, confusion, chronic fatigue, and autoimmune diseases.
"The use of any foreign object in the human body has potential risks,” Dr. Dung Nguyen, Director of Breast Reconstruction at Stanford Medicine, told SurvivorNet in an earlier interview. "Some are rare and are not known until years after they are in clinical use. It is our professional responsibility to inform our patients of these risks and any changes to them as our experience with the device broadens. The goal is not to cause a mass scare, but to provide evidence-based information in a relatable way so that women can make educated decisions about the use of breast implants for themselves."
Contributing: SurvivorNet Staff
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