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Breast Cancer Diagnosis Does Not Mean Breast Implants Have to Go: Presented at ASTRO

By Ed Susman

DENVER, CO -- October 19, 2005 -- Women who have cosmetic breast implants and subsequently learn they have early stage breast cancer may undergo lumpectomy and still retain their implants, doctors reported here at the 47^th annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

"The fact that a woman has a breast implant does not appear to impact outcomes if she wants to continue breast conserving surgery," said Rosalyn Morrell, MD, Resident in Radiation Oncology, Chandler Regional Hospital, Chandler, Arizona, United States.

Dr. Morrell and colleagues conducted a retrospective analysis of procedures involving women with breast implants, gathering data from the patient's workplace, the Mayo Clinic, Scottsdale, Arizona, and other Mayo Clinic facilities in Jacksonville, Florida and Rochester, Minnesota.

The researchers examined the charts of 26 women treated between 1994 and 2004. "We found that 22 of the women had good results, achieving a 1 or 2 on the Baker Classification [scale]," Dr. Morrell said. In the Baker Classification a score of 1 means the breast looks and feels normal after surgery. A score of 2 is also considered to be cosmetically acceptable. Scores of 3 or 4 are usually considered unacceptable.

Four women who scored 3 or 4 on the Baker scale underwent removal of their original implant and had subsequent cosmetic surgery to create a more normal looking breast, Dr. Morrell said in her poster presentation October 18^th.

Dr. Morrell noted that after an average of 3 years of follow-up, all the women remain breast cancer free.

She said that with the growing popularity of breast augmentation surgery -- at 300,000 women in 2004 -- the odds are increasing that more women with implants will present for lumpectomies. She said that current statistics indicate that breast implants do not increase the likelihood of having breast cancer.

The case analysis indicated that the only significant risk factor for breast cancer in the group of women studied was age.

Gregory Swanson, MD, Associate Professor of Radiation Oncology and Urology, University of Texas Health Science Center, San Antonio, Texas, United States, commented that in the past, when a woman with an implant was diagnosed with breast cancer, doctors would routinely remove the implant as part of the surgical treatment.

"Then we had a woman who said she didn't want the implant removed and asked us to proceed without taking it out," said Dr. Swanson, who was not part of the study. "We did, and she did well. We have now done a handful of women similarly without any problems."

Dr. Swanson, said that his experience has been similar to Dr. Morrell's and suggested that for women with early stage breast cancer who have implants, there should be no particular problem, depending upon the anatomy of the lesions, to preserving the implants.

Dr. Morrell said advances in surgical techniques, imaging techniques and radiation technology makes it more feasible to perform breast conservation surgery with radiation -- the standard of care for the procedure -- without adversely impacting how the implant feels in the breast.

"Past research, which showed only a 50% satisfactory outcome, was based on a small sample of patients and older radiation techniques," Dr. Morrell said. "Therefore, we investigated a larger group of women treated with radiation using newer techniques that refuted the reports of poor cosmetic outcome among patients."

"This treatment strategy is likely to be favored by the population of patients who were interested enough in the appearance of their breasts to have undergone prior augmentation surgery," Dr. Morrell said.


[Presentation title: Results of Primary Radiation Therapy for Breast Cancer in Cosmetically Augmented Patients. Abstract 2042]

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