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Implants No Bar to Conservative Surgery in Early Stage Breast Cancer: Presented at SSO

By Michael Smith

ATLANTA, GA -- March 7, 2005 -- Women with breast cancer can be good candidates for conservation surgery even if they have breast implants, and the results can be cosmetically "superlative," a U.S. surgeon says.

In the only prospective study of breast conserving surgery among women with breast implants, the cosmetic outcome was rated either excellent or good, said Dr. Nazanin Khakpour, MD, Breast Surgery Fellow, Department of Surgical Oncology, M.D. Anderson Cancer Center, Houston, Texas, United States.

The catch is that the 14 women in the study were "highly selected," Dr. Khakpour said during a presentation here on March 5^th at the Society of Surgical Oncology 58^th Annual Cancer Symposium. They women, who had a median age of 48 years, had had their implants for a median of 28 years, and their cancers were at an early stage, he added.

Traditionally, "when patients have implants, they have to get them removed (before treatment), because of the fear of radiation effects on the implant" including contraction and change of shape, Dr. Khakpour said. "Because the breasts are small in the first place (without the implants), they generally have a mastectomy with reconstruction."

But the fear of radiation effects may be exaggerated, she said, at least in women whose implants are well-established and who have early-stage cancer: The women, their radiation oncologists, and their surgeons independently rated the results at the top of the 4-point Baker scale for contracture.

After a median follow-up of 38 months, the women and their doctors remained happy with the cosmetic outcome, she said. There have been no cancer recurrences, she added, but they would not be likely so soon in this population.

Most of the women in the study had sub-pectoral implants -- beneath the pectoral muscle -- but three had subglandular implants. There appears to be no difference in the results between these two groups, Dr. Khakpour said.

One of the women in the study had bilateral cancer, so that 15 breasts in all were treated in the study, Dr. Khakpour said. Of those, she said, five had ductal carcinoma in situ, nine had stage 1 infiltrating ductal carcinoma and one had stage 2 infiltrating ductal carcinoma.

None of the women required re-operation, and the most common complications were skin reddening and peeling, which cleared up quickly, she said.


[Presentation title: Patients With Augmented Breasts Are Candidates For Breast Conservation Therapy. Abstract P66]

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