SILICONE CONTROVERSY - A SURVEY OF WOMEN WITH BREAST-CANCER AND SILICONE IMPLANTS

Background: During the past 3 years, there has been a highly publicize d debate concerning the potential medical complications of silicone br east implants. There have been no studies that have addressed the effe ct of this controversy on women with a history of breast cancer who ha ve undergone breast reconstruction with silicone implants. Purpose: Th is study was undertaken to understand the concerns of such women regar ding their breast reconstructions and to assess what impact the silico ne implant controversy had on them. Methods: One hundred seventy-four randomly selected women who had undergone reconstructive surgery with silicone implants subsequent to mastectomy for treatment of breast can cer were interviewed by telephone from February through May 1992. (A m oratorium on use of silicone breast implants, imposed by the Food and Drug Administration, extended from January through April 1992.) These women, a subset of 359 mastectomy/reconstruction patients of one unive rsity-based plastic surgeon, had their first permanent prostheses plac ed between 1985 and 1990. The interview included questions designed to elicit information about women's experiences with reconstruction and reactions to the controversy. Results: All study participants were awa re of the controversy surrounding silicone implants. Seventy-six perce nt stated that breast reconstruction helped them cope with cancer, and only 16% had regrets about reconstruction. Many respondents had misco nceptions about the nature of possible complications from silicone imp lants. Fifty-five percent were worried about the implants, vet only 13 % considered having them removed as a result of the controversy. Only 27% indicated they would be completely likely to choose silicone impla nts again. The majority of women were unwilling to accept substantial risks of complications from implants, but there was variability in the level of risk that respondents would tolerate. Conclusions: A majorit y of women who have had breast reconstruction using silicone implants after treatment of breast cancer believe that implants helped them cop e with the cancer. However, a sizeable proportion of such women are wo rried about possible medical complications that may develop as a conse quence of silicone breast implants. Many would likely not choose these implants today. Implications: The true risks associated with silicone implants will ultimately be known. In the meantime, health care provi ders need to address patients' concerns about these implants. Informat ion and guidance regarding the potential benefits and risks of breast implant devices should be provided to women with breast cancer who are considering treatment options.