Breast Implants and Breast Cancer Causation and Diagnosis

George Commons, MD

Article by
Palo Alto Plastic Surgeon

 

There are many ways to look at this. Do breast implants make the breasts harder to examine? The answer is yes they do. Could breast implants mask a cancer? The answer is yes they can and particularly if on top of the muscle. The reason is that breast tissue grows down into the muscle and if under the implant it is impossible to feel or see radio-graphically. This of course is a reason to go below the muscle but such masking is rare. Breast implants make mammography more difficult and require more views and more radiation. A cancer could be thus missed because of breast implants. Gel implants are more problematic than saline and make mammography even more difficult. Do radiologists like breast implants? Of course they do not. Their job is harder reading mammograms and you can bet that on every reading containing breast implants they always state the following. The mammograms showed no cancer or suspicious areas but of course there were breast implants that made reading uncertain or more difficult That statement is always there. The radiologists are protecting themselves just in case. Do breast implants make self examination more difficult? Of course they do. There is a confusing implant and although self exam can be done it is more difficult and more uncertain. Do breast implants get calcium in the capsule and is this a problem in examining the breasts by hand or by mammograms? Yes braest examination is more difficult by far, if calcium is in place, both by hand and mammography. Calcium and the entire capsule is nearly impossible to completely remove and when removal is done it takes many hours and blood loss is significant. Fortunately calcium in capsules is not common with modern implants. But it is ot zero. Does the silicone in the sheaths of the gel or saline implants cause cancer? No there is no evidence of that. Does gel bleed (and all gel implants bleed) into the breast tissue or muscle cause cancer? No it does no. Do breast capsule contractures make it harder to examine the breasts either by hand or mammography? Yes capsules make exam harder. Is there any difference between cancer threat with smooth and with textured surface. No difference has been shown but when textured breast implants are removed there is often bloody fluid around them secondary to the rubbing on the tissue. Irritation and trauma may cause cancer in some situation but none proven here. Do larger breast implants pose a greater threat? Well larger breast implants make it even more difficult to self examine the breasts and to do mammography. Are breasts exposed to more radiation after breast implants? Yes, absolutely. The requirement of more views on mammography sets the stage for this. So where are we regarding breast cancer and breast implants. Well, cancer has never been proven to be caused by breast implants but the risks are higher for stated reasons. If concern arise come and visit me for a consultation and we can talk. My Very Best, Dr George Commons of Palo Alto