Are Saline Implants Less Likely to Cause Breast Cancer Than Silicone Implants?

If breast cancer runs in my family, should I opt for saline implants? Why or why not?

Doctor Answers (12)

Breast Implants - Saline and Silicone risk of cancer

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Both implants are safe and neither has shown significant increase risk for cancer. Remember the saline implant is a silicone envelope with saline inside. Silicone implants have distinct advantages over saline implants in terms of performance: they wrinkle less and conform to a more natural breast shape, and also have a softer feel that is more breast-like. However, silicone implants have gained a reputation—possibly undeserved—for being less safe than saline implants.I think you have to answer this question in two ways:
  1. First, to address the perceived silicone toxicity by the public/patients which has not been substantiated by scientific studies and would be rare if it occurred at all.
  2. Secondly you have to address if they have ever been proven to be toxic.
The first question is easy to answer: there is no known toxicity from silicone gel breast implants. It has been studied by the FDA for more than three decades to establish its safety. Silicone is the most common material used in medical devices/implants. Examples include shunts that go from the brain to the abdomen (for hydrocephalus) which are left in for a lifetime, artificial finger joints, syringes, IVs, catheters (including ones that go next to the heart), surrounding pacemakers, and even oral anti-gas tablets.
The one possible exception may by the PIP implant made in France (generally not available in the USA). Most of the concerns about the PIP implant were about the use of non-medical silicone and manufacturing problems, and do not relate to implants used in the United States by board-certified plastic surgeons. This is not to say that breast implants, like any implant, can have problems; they may have to be removed and are not meant to last a life time. Common reasons for replacement include: capsular contracture, rupture, infection, change in breast size, and pain—but not for toxicity.
To answer the perceived toxicity of Silicone by the general public—this is quite a different matter.
Breast implants have been around since the 1960s. About 15 years ago Connie Chung ran an exposé, Face to Face with Connie Chung, claiming silicone implants were responsible for different health problems. This led to lawsuits, a huge windfall for lawyers, and the subsequent ban on silicone implants for first-time breast augmentation patients went into effect. They were always available for breast reconstruction (e.g. after mastectomy) and replacement of existing silicone breasts. Also, please note that saline implants are still covered by a silicone envelope.
Soon after, a ban on silicone implant use became worldwide. This lasted for years until more than 100 clinical studies showed that breast implants aren’t related to cancer, lupus, scleroderma, other connective tissue diseases, or the host of other problems they were accused of causing.
June 1999, The Institute of Medicine released a 400-page report prepared by an independent committee of 13 scientists. They concluded that although silicone breast implants may be responsible for localized problems such as hardening or scarring of breast tissue, implants do not cause any major diseases such as depression, chronic fatigue syndrome, lupus or rheumatoid arthritis, etc.
The Institute of Medicine is part of the National Academy of Sciences, the nation’s most prestigious scientific organization.
Eventually, a federal judge dismissed/rejected the lawsuits, declaring them junk science and ended for the most part the barrage of lawsuits. This led to the present reintroduction of silicone implants years ago and their approval by the FDA. Interestingly enough, most of the rest of the world reintroduced them many years prior to the United States.
 Despite the fact that there is no known toxicity of silicone gel breast implants, the possibility of a “silent rupture,” undetectable except by MRI, has been enough to make many women opt for saline implants or wait for a better product to come along. The time will be here most likely within a year or so with the advent of the Ideal Implant, the name given to a new design saline hybrid implant. It has the natural feel of silicone and safety of saline.
Saline implants, though providing peace of mind by being perceived as safer than silicone, often do not create a result that seems as natural. Wrinkling, scalloping, a globular shape, and water balloon-like feel, and increased risk of capsular contracture have been the trade-off for peace of mind with breast implants. The Ideal Implant solves many if not all of these concerns.
The Ideal Implant is one of the major technological advances to come along in the past few decades in implant manufacture. Using a novel design with internal baffles, the saline implant is manufactured to achieve a similar feel and performance comparable to a silicone implant. Approximately 95% of both patients and their surgeons expressed satisfaction at the current two-year data point by the FDA. The Ideal Breast Implant is soon to be released in the US market, hopefully with in the year.


Orange County Plastic Surgeon
5.0 out of 5 stars 47 reviews

Are Saline Implants Less Likely to Cause Breast Cancer Than Silicone Implants?

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Hello!  Thank you for your question!  This a great question, which is often asked by patients.  The answer is no - there is no link to breast implants, either saline or silicone, and cancer.  All supporting literature has demonstrated this fact and no association with cancer, autoimmune disorders, or autoinflammatory disorders.  

It is known that women are more in tune with their breasts and more diligent with examination and feeling/knowing the contour of her breasts, thus able to identify any abnormality sooner.  Imaging studies of the breasts are similar to imaging without breast implants and cancers are not hidden either by the presence of breast implants.  You should remain proactive with your monthly self examination, annual clinical examination, and mammograms beginning at age 40 (unless family history, as directed by the Radiological Society).  Best wishes!  Hope that this helps!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Breast Implants and Cancer

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As of this writing, there are no studies that show an increase in placement of breast implants, (saline or silicone), and breast cancer. 

Jeffrey Roth, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 9 reviews

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Breast Implants and Mammograms

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Mammography can still be performed with breast implants in place. Mammography technicians are trained to use specialized techniques for women with breast implants that help to image the breast tissue around the curved surface of the implants. Be sure to let the mammography provider know that you have breast implants when you schedule your mammogram.

It is not possible to obtain a mammogram by imaging through the implants, only around them. Breast implants therefore potentially do reduce a radiologist's ability to visualize breast tissue completely. This is more of a concern with implants placed immediately behind the breast ('sub-mammary', aka 'sub-glandular' position), so for that reason the sub-pectoral position is strongly preferred.

There is no conclusive evidence which shows that women with breast implants are diagnosed with breast cancer at a later stage than women without implants - which one would expect if breast implants actually delayed the detection of breast cancer. Likewise, women with breast implants do not appear to have a higher mortality rate from breast cancer compared to women without breast implants. Breast implants do not obscure or interfere with patient self-examination or physician breast examination, which are at least as important as (if not more important than) mammography for breast cancer screening.

Mammography is currently the recommended mass screening test for breast cancer, but it has significant limitations due to a high number of false positives (which leads to biopsies when no cancer is actually present) and false negatives (which means a cancer is missed when it is present). The most sensitive and specific radiologic test for breast cancer is a contrast-enhanced MRI scan, which refers to an MRI that is enhanced by the administration of an intravenous 'contrast' agent. The contrast agent helps to 'light up' a breast cancer on the MRI scan when one is present. Breast implants do not interfere with breast MRI scanning in any way.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 42 reviews

No

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There are many scientific studies that show that neither silicone or saline implants cause breast cancer.

E. Anthony Musarra II, MD
Atlanta Plastic Surgeon
4.0 out of 5 stars 9 reviews

Breast implants and cancer

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It is important to know which relatives developed breast cancer and at what age.  Cancer in close relations (sister, mother, maternal mother, maternal sister) may be an indication of increased risk of cancer for you, especially if those cancers occurred in your female relatives before menopause.  BRCA gene screening may be indicated.

 

As far as implants are concerned, saline and silicone have the same safety profile regarding cancer. 

Daniel Greenwald, MD
Tampa Plastic Surgeon
5.0 out of 5 stars 13 reviews

Breast cancer and implants

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There is no evidence that saline or silicone implants have any association with developing breast cancer.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Cancer with breast implants

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Neither saline or silicone breasts implants are shown to increase the incidence of breast cancer.  A super rare form of lympoma has been reported.  Family history is an important factor in breast cancer.  Mammograms may be impeded somewhat by implants placed above the muscle.   Donald R. Nunn MD Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

Breast Implants

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There has been no evidence that either type of implant has been linked to breast cancer.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 reviews

BREAST CANCER

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There is no evidence that either Saline or Gel implants cause breast cancer.  Detection of breast cancer may be more difficult by mammogram less so if the implants are placed beneath the muscle.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.5 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.