CAN BREAST RECONSTRUCTION WITH GEL-FILLED SILICONE IMPLANTS INCREASE THE RISK OF DEATH AND 2ND PRIMARY-CANCER IN PATIENTS TREATED BY MASTECTOMY FOR BREAST-CANCER

An increased risk of cancer and autoimmune disease associated with gel -filled silicone implants has been suggested recently, but these possi ble detrimental effects have not been adequately studied in patients w ith breast cancer. In order to evaluate these effects, we have studied 146 patients with breast cancer treated by mastectomy at the Gustave Roussy Cancer Institute between 1965 and 1983 and who received a gel-f illed silicone implant for immediate or delayed breast reconstruction between 1976 and 1984. These patients were compared with 146 matched c ontrols with breast cancer who were treated in the same center by mast ectomy without breast reconstruction and were matched for age at diagn osis (within 10 years), year of diagnosis (within 3 years), stage, his tologic type of the tumor, histopathologic grade, and nodal status. Th e relative risks of death, relapse, and second primary cancer were est imated by means of the Cox proportional hazards model stratified on ag e at diagnosis. The risks of distant metastasis and death due to breas t cancer were significantly lower in the breast reconstruction group t han in the control group. The risks of local recurrence, second breast cancer, and second primary cancer in another site than the breast wer e not significantly different between the two groups of patients. Our results do not support the hypothesis of a detrimental effect of gel-f illed silicone implants either in the course of breast cancer or in th e risk of death due to other diseases.