In the U.S., both saline and silicone implants are approved by the Food and Drug Administration (FDA) for cosmetic and reconstructive use. Both types of implants can enhance the size of the breasts during breast augmentation. They can also be used to replace breast tissue following mastectomy.
For years, concerns and rumors about the safety of breast implants, particularly silicone implants, have continued to circulate. In the 1990s, silicone implants were even taken off the market because of concerns that they caused cancer and other health issues.
In 2006, after no links were found between these implants and cancer, the FDA approved silicone implants once again for women over the age of 22 for cosmetic breast augmentation and for women of all ages who need reconstructive surgery. However, many people still think that breast implants cause cancer, and it’s important for prospective patients to learn the facts so they can feel comfortable about moving forward.
If you are considering implants, it’s important to understand their safety and risks, including any connection they might have to cancer. If you are currently being treated for breast cancer and have a mastectomy scheduled, you might also want to learn more about the use of implants in reconstructive surgery.
What Is Breast Cancer?
When a person is diagnosed with breast cancer, it means that cells in the breast have begun to mutate and multiply more quickly. Although most of the patients who are diagnosed with breast cancer are women, this type of cancer can also occur in men from time to time.
According to the Centers for Disease Control and Prevention (CDC), breast cancer can develop in different areas of the breast. The most common locations for breast cancer are in the ducts, which deliver milk to the nipples, or in the lobules, which produce milk. A tumor can also form in the connective tissue of the breast.
Many types of breast cancer are invasive, meaning they can spread to other areas of the body if the cancer isn’t detected and treated quickly. As the American Cancer Society notes, breast cancer can spread if the cells get into the bloodstream or lymph system.
Cancer that spreads is said to have metastasized. Usually, it moves to the lymph nodes first, then to other organs in the body. Treating breast cancer before it spreads helps to increase the survival rate.
Symptoms of Breast Cancer in Women
One of the most common signs of breast cancer is a new lump in the breast or near the armpit. Often, cancerous lumps aren’t painful and feel uneven or jagged. Although a lump that is painful or smooth is often benign, it could also be a sign of cancer, which is why it’s important to see a doctor if you notice any new lumps or masses in your breast.
When looking for lumps, it’s important to remember that not all lumps are cancerous. In some cases, the feel of your breasts can change due to hormone fluctuations or changes in your weight. It’s important to know what your breasts feel like normally when looking for lumps or performing a breast self-exam.
In addition to a lump or mass, there are a few other signs and symptoms of breast cancer to keep an eye out for. Symptoms can include:
- A change in the texture or appearance of the breast skin (for examples of this, see inflammatory breast cancer rash pictures).
- Painful nipples or nipples that pull inward.
- Bleeding or other discharge from the nipples (not milk).
- A change in the breast’s shape or size.
- Swelling of the breast or lymph nodes under the arm.
In some cases, breast cancer doesn’t present any symptoms. Seeing your gynecologist for regular exams is important for early cancer detection. If you are over age 40, your doctor might recommend mammograms to screen for breast cancer.
Screening for Breast Cancer
There are several ways to examine the breasts and screen for cancer. Some women perform breast self-exams at home to look for changes or lumps. The ideal time to perform a breast self-exam is between three and five days after the start of your period.
Not all women perform self-exams and they aren’t always an effective tool for detecting cancer. Another option is to have a physician perform a clinical exam during an annual physical or check-up, feeling the breasts for any changes.
The gold standard in breast cancer screening is the mammogram, which takes an X-ray image of the breasts. Mammograms can pick up tumors that are too small to be felt during a clinical or self-exam.
When you will need to start having mammograms depends on several factors, such as your family history of breast cancer and your overall risk. Often, the imaging procedure is recommended for women starting at the age of 40. Statistics have shown that women between the ages of 50 and 69 who have regular mammograms are less likely to die from breast cancer.
Depending on the results of the mammogram, your doctor might order or perform a breast biopsy to determine if cancer is present.
How Do Women With Implants Check for Breast Cancer?
If you have breast implants, it’s still important to follow the screening schedule recommended by your physician to increase the chances of detecting cancer in the early stages.
The mammogram experience is likely to be different for women with breast implants than it is for women without implants. A saline or silicone implant can make it harder for the X-ray to take images of certain parts of the breast, as the American Cancer Society points out.
Let the technician know that you have implants before they begin the mammogram. It might even be a good idea to share that information when you make the appointment. To get the most accurate imaging of the breast tissue, the technician might take additional pictures of the breast, known as implant displacement (ID) views.
To capture ID views, the implant is pushed against the chest wall with the breast tissue arranged in front of it. Usually, the submuscular placement of the implants makes it easier to capture ID views.
Breast Cancer Implant Reconstruction
After a mastectomy, a woman might decide to have breast reconstruction, which rebuilds the breasts surgically. There are several ways a surgeon can reconstruct the breasts after removal.
One option is to use tissue from the woman’s own body to create natural-looking breasts. The other option is to use implants for breast reconstruction. Depending on your preference, a surgeon can use saline or silicone implants to rebuild the breasts.
Breast reconstruction with implants can be performed right after the mastectomy. It’s also possible to delay the reconstruction. Both options have pros and cons.
One benefit of immediate reconstruction is that you don’t have to adjust to life without breast tissue for any length of time. It can also be easier for the surgeon to manipulate the skin of the breasts if the reconstructive surgery is performed immediately.
Delayed reconstructive surgery is often recommended for women who will receive radiation therapy as part of their breast cancer treatment. If you decide to put off the surgery, the surgeon will most likely put tissue expanders in the breast area to make room for implants at a later date.
Do Breast Implants Cause Breast Cancer?
Neither saline nor silicone-filled implants cause breast cancer. The FDA has found no connection between breast implants and any type of breast cancer. Research from the Susan G. Komen Foundation backs up the FDA’s findings.
In fact, the foundation points to studies that seem to suggest that women with breast implants seem to have lower rates of breast cancer than women without implants. There could be many reasons for reduced cancer rates in these studies, though.
For example, women who decide to have breast augmentation are often thinner than those who don’t have the surgery. Women with implants might also have fewer risk factors for cancer, such as reduced alcohol intake or no family history of cancer. It’s hard to say for sure, but the facts should help to put prospective breast augmentation patients at ease.
What Is Breast Implant-Associated Anaplastic Large Cell Lymphoma?
While there’s no evidence to suggest a link between breast cancer and breast implants, there does seem to be a connection between certain types of silicone implants and a type of lymphoma known as breast implant-associated anaplastic large cell lymphoma (BIA ALCL).
ALCL is a type of non-Hodgkin’s lymphoma, a cancer that affects our immune systems. According to the Mayo Clinic, ALCL can develop anywhere in the body but most often forms in the skin or lymph nodes. In cases of BIA ALCL, cancer often develops next to a breast implant, in the scar tissue.
It’s important to note that ALCL is not breast cancer, but a type of lymphoma. It’s also important to stress that though there seems to be a link between ALCL and certain types of breast implants, this type of cancer is still very rare.
As WebMD notes, up to 96% of women with BIA ALCL have textured implants. The rate of occurrence is around 1 in 50,000 women.
Textured Implants vs. Smooth Implants
In addition to being filled with silicone or saline, implants can have a smooth or textured outer shell. There seems to be a connection between textured implants and the risk of BIA ALCL but the exact link between the two isn’t clear.
Should You Remove Textured Implants?
In 2019, the FDA issued a breast implant recall (cancer link concerns cited) of certain types of textured implants and tissue expanders to be on the safe side. If you have the implants that were included in the recall, should you remove them or is it safe to leave them in place?
Generally speaking, you don’t have to take out textured implants due to the risk of BIA ALCL. The cancer is still very rare.
If you are interested in implant removal, you can discuss your options with your surgeon. You might decide to replace the implants with smooth ones or remove them completely.
Should you decide against removing or replacing your implants, pay attention to breast implant cancer symptoms and let your doctor know if you notice any changes in your body. Lymphoma symptoms in women to look out for include breast swelling and pain, lymphoma rash, or fluid buildup, according to the American Society of Plastic Surgeons.
Treating BIA ALCL
Treatment for BIA ALCL depends on how advanced the cancer is and whether it has spread or not. In the early stages, treatment might involve removing the implant and surrounding scar tissue. You might also need chemotherapy and radiation. Depending on the situation, an experimental clinical trial for treatment might be available.
What Is Breast Implant Illness?
Some women with breast implants complain of symptoms of a condition that’s been labeled breast implant illness (BII). BII isn’t a type of cancer and is poorly understood. It might have nothing to do with the presence of implants and could be a result of an autoimmune disease or fluctuating hormone levels.
The symptoms of BII can develop at any time after breast implant surgery. Some women have symptoms right away while others don’t have any symptoms for years. It’s also possible that the symptoms are a correlation and aren’t caused by implants at all.
Some of the symptoms associated with breast implant illness include:
- Brain fog
- Joint pain
- Memory loss
If you are experiencing any of the above symptoms and are concerned, your best option is to schedule a consultation with your doctor to discuss your options. They might schedule bloodwork to see if certain antibodies are present or to test your hormone levels.
Reconstructive surgery with implants is by far the most common type of breast reconstruction after mastectomy. While women can choose between saline or silicone implants, silicone tends to be more popular because of its softer, more natural feel.
The risks of having implants after breast cancer are relatively low. As with all surgeries, there is the risk of infection or bleeding. Some types of implants are linked to BIA ALCL but the risk of developing lymphoma after implant surgery is very, very low.
You can have breast augmentation even if you have a family history of breast cancer. In fact, some women who have a higher risk of cancer due to their genes and family history decide to have preventative mastectomies and to use implants to reconstruct the breasts afterward.
While there’s no way to eliminate the risk of breast cancer entirely, eating a healthy diet, maintaining a healthy weight, and avoiding excessive alcohol consumption can all help reduce the risk of cancer. Regular screenings, such as mammograms, can also help you detect cancer in the earliest stages when it’s easiest to treat.
Learn More About the Risks and Benefits of Breast Augmentation
Talking to a board-certified plastic surgeon can help you get answers to your questions about breast implants, breast cancer, and lymphoma causes. Whether you have implants already and are concerned about their safety or are considering breast augmentation but want more information, a consultation with a plastic surgeon can put your mind at ease.
Based in Houston, Texas, Dr. Paul Vitenas is a board-certified plastic surgeon who specializes in breast surgeries. He can answer your questions and help you choose the type of implants that will work best for you. To schedule your consultation, call 281-484-0088 today.