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A large study conducted by researchers from the National
Cancer Institute (NCI) finds no correlation between silicone-filled
breast implants and
breast cancer risk. Silicone implants had been on the market since 1962 but
were
banned by
the U.S. Food and Drug Administration (FDA) in 1992 after questions
arose concerning the safety of silicone leakage in the breast tissue
and other areas of the body. The NCI study, revealing no increased
breast cancer risk from silicone implants, is the first part of an
analysis ordered by the U.S. Congress to evaluate the long-term
health effects of silicone implants.
In the study, researchers analyzed medical records and
collected data from 13,500 women who had implant surgery for
cosmetic reasons between 1962 and 1989. These women were compared to
both the general population and to women who had received other
types of plastic surgery. The average length of follow-up was 12.9
years among the women with implants and 11.6 years among the
comparison group.
"For women followed for more than 10 years, there was no
change in breast cancer risk," said Louise A. Brinton, PhD,
principal investigator from the NCI’s Division of Cancer
Epidemiology and Genetics (DCEG) in Bethesda, Maryland, in a press
release. The NCI study is one of the largest studies on the
long-term health effects of silicone breast implants ever conducted.
However, the study only included women who had implants placed for
cosmetic reasons and did not include any breast cancer survivors.
According to the NCI, breast implants have also been linked
to later breast cancer diagnoses. This may be due to the fact that
the x-rays used for
mammographic
imaging
of the breasts cannot penetrate silicone or
saline implants well enough to image the overlying or underlying
breast tissue. This makes cancer more difficult to detect at an
earlier age. Therefore, some breast tissue (approximately 25%) will
not be seen on the mammogram, as it will be covered up by the
implant. In order to visualize as much breast tissue as possible,
women with implants typically undergo
diagnostic
mammography
instead of screening
mammography. Diagnostic mammography requires
additional mammography views.
In the NCI study, the researchers did find that breast cancer
was detected at a later
stage among some women with breast
implants, compared to women without implants. Also, fewer cases of
early stage "
in situ" breast cancer (cancer that has not
spread past the boundaries of tissue where it originally developed)
were also found among women with implants, compared to women without
implants. However, the researchers say that the differences were not
statistically significant and require further investigation.
According to the NCI, it is estimated that between 1.5
million and 2 million American women have had breast implant surgery
since implants first appeared on the market in 1962. Approximately
80% of women get breast implants for cosmetic reasons and 20% get
implants to reconstruct their breasts after breast cancer surgery
(mastectomy). Before silicone breast implants were banned, over 90% of
implants contained silicone, since these implants were thought to
cause the enhanced breast to look and feel more natural than saline
(salt water) filled implants. Currently, only breast cancer patients
who participate in closely monitored
clinical
trials
may get silicone breast implants.
There is much controversy surrounding silicone breast
implants. Many medical experts doubt silicone implants cause any
significant medical disease. However, many women who experienced
silicone leakage have reported symptoms such as
breast pain, fatigue, myalgias (muscle pain), arthralgias (joint pain),
hair loss, and memory loss. Future research will help to better
understand the long-term health effects of silicone breast implants.
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