Cosmetic and reconstructive surgery and risk of breast cancer

Cosmetic surgery of the breast has been performed since the onset of plasti c surgery and nowadays it is a part of cancer treatment. In the last decade s. cancer risk related to these procedures has been investigated, especiall y with regards to implant reconstructions. Experimental studies and clinica l trials have been published testing different filling materials of prosthe ses. first in animals and then in human bodies. In no human study has a can cer transformation been induced by filling materials. Moreover, in the case of implant placement no evidence of delayed diagnosis of local recurrence or primary cancer has been described in literature. With regards to autolog ous tissue reconstructions, they do not add an increased risk of recurrence s or secondary cancer. In addition, small areas of liponecrosis and liposcl erosis inside the flaps can be easily investigated with ultrasonography and /or with a mammogram. Another cosmetic procedure is frequently proposed to improve final aestheti c results in patients who underwent a breast reconstruction: a reduction ma stoplastly or mastopexy of the contralateral breast. This procedure adds a cancer benefit since a pathological examination of the reduction specimens is always performed. With regards to cosmetic breast augmentation, although the silicone prosthesis behind or above the gland decreased the percentage of breast tissue visualized with a mammogram, the ultrasonography allows a good evaluation both of the glandular tissue and the implant. In this pape r we evaluate experimental and clinical data in literature concerning cosme tic and reconstructive surgery and risk of breast cancer. We conclude that breast cosmetic surgery should be considered as a safe procedure if perform ed after a careful 'carcinogenic' check-up preoperatively and planned patho logical examinations of any specimen. (C) 2001 Harcourt Publishers Ltd.