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Breast Cancer After Augmentation Mammoplasty

From the Departments of Surgery (KAS, HS, WD, MJS), Medicine (JW), and Preventive Medicine (RS), Kenneth Norris, Jr. Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, and the Van Nuys Breast Center (PG), Los Angeles, California.

Correspondence: Address correspondence and reprint requests to: Dr. Kristin A. Skinner, Assistant Professor of Surgery, Kenneth Norris, Jr. Cancer Center, University of Southern California, 1441 Eastlake Avenue, MS74, Los Angeles, CA 90033; E-mail: kskinner @hsc.usc.edu

Background: It is thought that implants interfere with breast cancer diagnosis and that cancers in women who have had breast augmentation carry a worse prognosis.

Methods: A prospective breast cancer database was reviewed, comparing augmented and nonaugmented patients for details of histology, palpability, tumor size, nodal status, mammographic status, receptor status, nuclear grade, stage, and outcome.

Results: Ninety-nine cancers in augmented women and 2857 cancers in nonaugmented women were identified. Among these women, mammography was normal in 43% of those who had had augmentation and in 5% of those who had not. Augmented women were more likely to have palpable cancers (83% vs. 59%) and nodal involvement (48% vs. 36%), and less likely to have ductal carcinoma in situ (DCIS) (18% vs. 28%). When comparing only women younger than 50, the differences in invasiveness and nodal status lost significance. Cancers diagnosed in the 1990s were more likely to be nonpalpable and noninvasive than those diagnosed in the 1980s. This trend was more pronounced in the augmented population.

Conclusions: Augmented patients were more likely to have palpable cancers, although the overall stage and outcome were similar to those of nonaugmented women. Although there have been significant improvements in our ability to diagnose early breast cancer over the past two decades, mammography continues to be suboptimal in augmented women.

Key Words: Breast cancer • Augmentation Mammoplasty

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