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Current gel-filled breast implants correspond to the 5th generation, with improved materials for the content and shell. The semi-solid gel in these type of implants largely eliminates the possibility of silicone migration. Studies of these devices have shown significant potential improvements in safety and efficacy over the older implants with low rates of capsular contracture and rupture.

Controversy still existed about the safety of older implants until recent years regarding to the risk of breast cancer in these patients.

Here we present the key-points of a large study by Deapen and collaborators reviewing their results of the follow up of 3193 women who received breast implants between 1953 and 1980:

 

Name of the published study: Cancer Risk among Los Angeles Women with Cosmetic Breast Implants. Journal of Plastic and Reconstructive Surgery, June 2007. Pages 1987-1999.

Authors: Dennis M. Deapen, Dr.P.H., Elliot M. Hirsch, B.A. and Garry S. Brody, M.D.

From the Department of Preventive Medicine, Division of Plastic Surgery, and Keck School of Medicine, University of Southern California.

Patients and Methods: The records of women of Los Angeles receiving breast implants from the practice of 35 board-certified plastic surgeons were reviewed. The study included 3193 women who received breast implants between 1953 and 1980 available for follow-up, comparing them to the records of the Cancer Surveillance Program from Los Angeles.

Results: The median follow-up was 15.5 years, Breast cancer risk changed little over time since implant for the first 20 years. No significant risk was found for the women who were younger than the median age of 32 years as compared with those who were older. Between these patients, 43 cases of breast cancer were observed. This was less than expected for a population of the same characteristics without breast implants (A number of 62.3 cases was expected after statistical analysis).

Discussion: Patterns of breast and other cancers among women with cosmetic breast implants continue to be explored among several populations.

A group of 24,558 women with cosmetic breast implants was compared with a group of 15,893 women who underwent other cosmetic procedures in Canada between 1974 and 1989 (Brisson, J., Holowaty, E. J., Villeneuve, P. J., et al. Cance incidence in a cohort of Ontario and Quebec women having bilateral breast augmentation. Int. J. Cancer 118: 2854, 2006.). Followed through 1997, the implant patients experienced a reduced risk of breast cancer. When the number of observed breast cancers among the breast implant patients was compared with the number expected from the general population rate, the result was similar.

Similar results were reported from a 2002 study of 2171 Finnish women with cosmetic breast implants who were followed for cancer incidence through 1999 (Pukkala, E., Boice, J. D., Jr., and Hovi, S. L., et al. Incidence of breast and other cancers among Finnish women with cosmetic breast implants, 1970–1999. J. Long Term Eff. Med.Implants 12: 271, 2002)

Summary: Long-term follow-up of the Los Angeles Augmentation Mammaplasty Study shows lower than expected breast cancer risk, a finding that has been widely replicated.

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