ARE BREAST IMPLANTS ANTICARCINOGENIC - A 14-YEAR FOLLOW-UP OF THE LOS-ANGELES STUDY

Despite decades of use, the long-term safety of breast implants in wom en remains a concern. While the incidence of breast cancer among women has increased dramatically in the past decade, the implant-related ri sk of carcinoma of the breast only recently has received wide-spread a ttention. An additional concern is that the presence of the implant ma y delay tumor detection. This study allows examination of breast cance r risk and detection issues among patients with long-term exposure. We conducted a record linkage cohort study of cosmetic breast implant pa tients. We abstracted the records of the private practices of 35 board -certified plastic surgeons in Los Angeles County, California. We incl uded 3182 white women who received cosmetic breast implants between 19 53 and 1980. Spanish-surnamed women, nonresidents of Los Angeles Count y, and patients with prior subcutaneous mastectomy or breast cancer we re excluded. Cancer outcomes through 1991 have been ascertained throug h record linkage with the Los Angeles County Cancer Surveillance Progr am. With a median follow-up of 14.4 years, 31 breast cancer cases were observed, compared with 49.2 expected, based on Los Angeles County po pulation-based incidence rates (standardized incidence ratio = 63.0 pe rcent; 95 percent confidence limits: 42.8 and 89.5 percent). The distr ibution of stage of disease at diagnosis among women with implants did not differ from that of all similar breast cancer patients in Los Ang eles County. In Los Angeles County, augmentation mammaplasty patients experience a significantly lower than expected risk of breast cancer a nd no delay in breast cancer detection after an average of 14.4 years of exposure. While the linkage methodology allows the possibility of f ailing to detect diagnosed cancer cases and does not permit collection of some pertinent risk factors, the six other published epidemiologic studies on the topic also report breast cancer risk to be at or below the expected rate.