BREAST IMPLANTS AND CANCER

Background: Although silicone breast implants have been linked to vari ous short-term complications, less is known about their long-range eff ects, Most attention has focused on connective tissue disorders, but t he range of immunologic disturbances observed in women with implants s uggests that consideration also be given to other chronic diseases, in cluding cancer, The greatest attention has focused on breast cancer, g iven clinical reports suggesting an association and observations that mammographic visualization is deterred by implants, Findings from epid emiologic studies, however, actually suggest that breast cancer risk m ight be reduced among women with implants, although the biologic mecha nism remains undefined, In addition, most studies do not suggest that women with breast implants have more advanced breast cancer at diagnos is or a worse prognosis than those without implants, The majority of s tudies have focused on women who received implants for cosmetic reason s, with little previous investigation of women who received implants f or breast reconstruction following cancer surgery, In terms of other c ancers, animal as well as clinical data suggest potential risks of sar comas and hematologic cancers, including multiple myeloma, The risk of these cancers has not yet been adequately addressed by epidemiologic studies, although several ongoing studies should provide insights, It will be important for studies to consider effects of other lifestyle f actors as well as to analyze relationships according to duration of im plantation, a demonstrated determinant of implant deterioration, In ad dition, consideration should be given to type of implant, including im plants with polyurethane foam covers, which can leak toluene diamine, a demonstrated carcinogen in animals.