While post-mastectomy breast implants indubitably help
some cancer survivors' self-image, many experts wonder
if the procedure is worth it. Do the psychological benefits
of breast implants trump the potential longterm dangers
they supposedly bring about? New research could put this
fear of implants to rest.
A study in the January issue of
Breast Cancer Research looked at data collected
from three US cities and found that breast implants
don't lessen a mastectomy patient's survival odds —
in fact, the study's implant recipient group actually
had lower mortality rates.
SILICONE
LIFESAVERS
The research team led by Dr Gem Le stated flatly: "The
risks of breast cancer mortality and nonbreast cancer
mortality were lower in patients with implants than
in those patients without implants." Their data showed
breast cancer mortality in women receiving an implant
to be a much lower 12.4%, compared to 19.7% in implant-free
women.
Dr Le and his colleagues pored
over data collected from 4,968 women younger than 65
enrolled in the US-based Surveillance, Epidemiology
and End Results Breast Implant Surveillance Study from
1983 to 1989. The women had been diagnosed with early
or unstaged first primary breast cancer and had received
a mastectomy as part of their treatment. Patient outcomes
were followed for a median period of 12.4 years.
Twenty percent of those studied
received breast implants, most commonly the silicone
gel-filled sort (the researchers found no correlation
between the type of implant used and patient outcome).
Women who opted for implants were more likely to be
younger and to have had cancer that was confined to
a single breast. These results accounted for variations
in age, year of diagnosis, race, ethnic background,
stage of the cancer, grade of the tumor, histology and
use of radiation therapy.
The women with implants who died
during the followup period had similar causes of death
as those without implants, with one glaring exception:
three of the four patients who committed suicide were
implant recipients. Whether psychiatric consultation
should be part of the pre-implant process is a key question
that's likely to remain unanswered until a larger study
is undertaken.
MANY
QUESTIONS REMAIN
Exactly why the implant recipients had lower mortality
rates remains very much unclear. The authors wrote that
more research into possible socioeconomic and lifestyle
factors is needed.
The research team did, however,
speculate that the implants themselves aren't a factor
in the increased survival rates. "Because women with
breast implants may
be more closely followed in their
medical care, they may have recurrences diagnosed and
be treated earlier," wrote the researchers. "Furthermore,
psychological factors underlying a woman's decision
to obtain breast implants, including body image concerns
and self-esteem, may play a role in lifestyle behaviours
relevant to survival."
Breast Cancer Research 2005;7:R184-R193
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