title: A review of the oncologic and surgical management of breast cancer in the augmented breast: diagnostic, surgical and surveillance challenges.
abstract: BACKGROUND
  The challenges of managing breast cancer in women with augmented breasts include screening, diagnosis, oncologic and revisional surgery, and surveillance. In addition, women with augmented breasts frequently have greater expectations of cosmetic outcomes. More breast clinicians will be affected by these challenges as augmentation grows in popularity and women with implants reach the age range in which they are at higher risk of developing breast cancer. In the United States, more than 2 million women have undergone augmentation, making this the second most commonly performed cosmetic procedure. With a lifetime risk of developing breast cancer of 1 in 8, it is projected that more than 50,000 women who undergo augmentation each year in the United States will develop breast cancer at some point in their lives.
  
  
  METHODS
  This is a review of current practice based on an exhaustive literature search of PubMed, Google Scholar, and conference proceedings. A series of case studies is presented to illustrate mammographic changes and cosmetic outcomes in augmented breasts that have required treatment for breast cancer.
  
  
  RESULTS
  An evidence-based summary of recommendations has been produced to guide breast surgeons in managing this particular group of patients.
  
  
  CONCLUSIONS
  Management of breast cancer in previously augmented breasts presents a unique range of challenges. Patients can be reassured that the presence of an implant does not increase the risk of breast cancer developing or affect the prognosis if breast cancer does develop. Clinical judgement is made balancing surgical and oncologic principles to provide the best cosmetic outcome.
authors.affiliation: Academic Surgery (Breast Unit), The Royal Marsden NHS Trust, Fulham Road, London, UK. stang@doctors.org.uk
authors.forename: Sarah S K
authors.initials: SS
authors.lastname: Tang
authors.forename: Gerald P H
authors.initials: GP
authors.lastname: Gui
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D008327:Mammography; D008408:Mastectomy; D011379:Prognosis