Breast cancer after augmentation mammoplasty.
BACKGROUND
It is thought that implants interfere with breast cancer diagnosis and that cancers in women who have had breast augmentation carry a worse prognosis.


METHODS
A prospective breast cancer database was reviewed, comparing augmented and nonaugmented patients for details of histology, palpability, tumor size, nodal status, mammographic status, receptor status, nuclear grade, stage, and outcome.


RESULTS
Ninety-nine cancers in augmented women and 2857 cancers in nonaugmented women were identified. Among these women, mammography was normal in 43% of those who had had augmentation and in 5% of those who had not. Augmented women were more likely to have palpable cancers (83% vs. 59%) and nodal involvement (48% vs. 36%), and less likely to have ductal carcinoma in situ (DCIS) (18% vs. 28%). When comparing only women younger than 50, the differences in invasiveness and nodal status lost significance. Cancers diagnosed in the 1990s were more likely to be nonpalpable and noninvasive than those diagnosed in the 1980s. This trend was more pronounced in the augmented population.


CONCLUSIONS
Augmented patients were more likely to have palpable cancers, although the overall stage and outcome were similar to those of nonaugmented women. Although there have been significant improvements in our ability to diagnose early breast cancer over the past two decades, mammography continues to be suboptimal in augmented women.
Department of Surgery, Kenneth Norris, Jr. Comprehensive Cancer Center, Keck School of Medicine, University of Southern California. Los Angeles 90033, USA. kskinner@hsc.usc.edu
K A
KA
Skinner
H
H
Silberman
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Dougherty
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Gamagami
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J
Waisman
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Sposto
M J
MJ
Silverstein
D000230:Adenocarcinoma / Q000175:diagnosis; D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000209:etiology*; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000209:etiology* / Q000556:secondary; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects*; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis