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Breast Cancer in the Previously Augmented Breast: Do Implants Delay Detection?
Eugenia H. Cho, BS, Ruya Zhao, BS, Rachel Greenup, MD, Scott T. Hollenbeck, MD, FACS.
Duke University Medical Center, Durham, NC, USA.

PURPOSE:Patients considering breast implant augmentation fear that implant placement may impair the early detection of breast cancer and lead to worse prognosis. This study assessed whether breast implant augmentation (IA) is associated with more advanced breast tumors at the time of therapeutic mastectomy.
METHODS:Breast cancer stage distribution at diagnosis was retrospectively analyzed for 90 women with prior IA who underwent therapeutic mastectomy at a single institution from 1993-2014 (mean follow-up=3.6±3.6 years). Comparison was made to all women without IA undergoing therapeutic mastectomy at the same institution in 2010 (n=171). Sub-analyses were performed according to implant characteristics.
RESULTS:Ninety women with prior IA underwent mastectomy for 96 breast cancers at a mean interval of 15.4±10.8 years after IA surgery. Mean age at cancer diagnosis was 52.4±10.7 years. Compared to non-IA women, women with prior IA were leaner (p<0.01) and more commonly white (p<0.01). Breast cancer stage at diagnosis was similar for both groups (p=0.28;Table 1). Among IA patients, subglandular implants were associated with later-stage breast cancers (p<0.01;Table 2) and detection by self-palpation (p=0.04), compared to subpectoral implants.
CONCLUSION:This institutional study is the largest to assess breast cancer detection among women with prior IA according to implant characteristics. Breast cancer stage distribution did not differ for women with and without IA. In the IA cohort, women with subglandular implants presented with more advanced breast tumors in palpable form.


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