Textured implants and cancer?

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Woman with breast implants are urged not to be alarmed by recent reports on a cancer link.

A colleague of Dr Magnusson’s, plastic surgeon Associate Professor Anad Deva, from Macquarie University in Sydney, recently published an article about breast implants, capsular contracture and a theoretical association with a rare type of cancer in a leading international plastic surgery journal.

Associate Professor Deva was misreported after an interview with Sue Dunlevy with the Herald Sun. She has subsequently corrected her online article after the inaccuracy was pointed out by the Australian Society of Plastic Surgeons.

One of the comments incorrectly reported was that 30% of women having breast reconstruction with implants develop cancer. This was a complete misquote: Associate Professor Deva said 30% of this group develop contracture, a hardening around the reconstruction (with no reference to cancer).

The research:

His research was directed at investigating any potential relationship between bacterial contamination of breast implants at the time of insertion, capsular contracture around implants and the body’s response to these bacteria. The information was derived from animal studies in pigs where bacteria was purposely implanted with an implant and also from established implant capsules removed from women undergoing surgery for this problem.

His team was able to confirm previous reports and add new details to the body of information we already know in relation to breast implant surgery. Increasing numbers of bacteria on the surface of a breast implant can contribute to capsular contracture. Once the bacteria are on an implant, they grow in greater numbers on textured implants.

Textured implants however do have other benefits because of the different interactions with the body due to their surface. This is why they are used.

They also demonstrated that the long-term presence of bacteria on the surface of an implant leads to a response from the body associated with inflammatory cells, T-cell lymphocytes.

They did not demonstrate any cancer in either the animal study or human implant capsules.

He did observe that these cells are similar to those linked to a rare type of lymphoma that has been detected in 170 women world wide with breast implants.

Perspective: 

Putting this into perspective, there are possibly 10 million women worldwide with breast implants. This represents roughly 1 lymphoma for each 59,000 women (0.0017%). By contrast, the usual types of breast cancer occurs in about 1 in 10 women (10%).

What was not reported: although we are already familiar with most of this, the surgical goal is to avoid contamination rather than manage it.

The up to date surgeon uses a number of steps specifically to minimise this contamination at the time of surgery. Associate Professor Anad Deva referred to these steps that can be taken to avoid implant contamination at the time of surgery.

At Allure, Toowoomba:

In my practice, we have been employing these steps to minimise contamination for many years and as new information becomes available such as this, it is evaluated and assimilated.

This information does not change our current practice at Allure. It does add to the body of evidence that we have in relation to achieving the best results for our patients and improving patient safety.

Take home message:

While it is important that women are not alarmed by this information, it is essential that patients are aware of how to identify any changes such as a lump around the breast implant and that they are followed up for any changes.

This highlights the importance of implant procedures being conducted by properly trained plastic surgeons in appropriately accredited facilities.

 

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On November 14, 2014
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