Breast cancer after augmentation mammoplasty

Background: It is thought that implants interfere with breast cancer diagno sis and that cancers in women who have had boast augmentation carry a worse prognosis. Methods: A prospective breast cancer database was reviewed, comparing augme nted and nonaugmented patients for details of histology, palpability, turne r size, nodal status, mammographic status, receptor status, nuclear grade, stage, and outcome. Results: Ninety-nine cancers in augmented women and 2857 cancers in nonaugm ented women were identified. Among these women, mammography was normal in 4 3% of those who had had augmentation and in 5% of those who had not. Augmen ted women were more likely to have palpable cancers (83% vs. 59%) and nodal involvement (48% vs. 36%), and less likely to have ductal carcinoma in sit u (DCIS) (18% vs. 28%). When comparing only women younger than 50, the diff erences in invasiveness and nodal status lost significance. Cancers diagnos ed in the 1990s were more likely to be nonpalpable and noninvasive than tho se diagnosed in the 1980s. This trend was more pronounced in the augmented population. Conclusions: Augmented patients were more likely to have palpable cancers, although the Overall stage and outcome were similar to those of nonaugmente d women. Although there have been significant improvements in our ability t o diagnose early boast cancer over the past two decades, mammography contin ues to be suboptimal in augmented women.