title: Do breast implants adversely affect prognosis among those subsequently diagnosed with breast cancer? Findings from an extended follow-up of a Canadian cohort.
abstract: BACKGROUND
  Cosmetic breast implants may impair the ability to detect breast cancers. The aims of this study were to examine whether implants and implant characteristics are associated with more advanced breast tumors at diagnosis and poorer survival.
  
  
  METHODS
  Study population includes all invasive breast cancer cases diagnosed during follow-up of the large Canadian Breast Implant Cohort. A total of 409 women with cosmetic breast implants and 444 women with other cosmetic surgery were diagnosed with breast cancer. These women were compared for stage at diagnosis using multinomial logistic regression models. Cox proportional hazards regression models were used for breast cancer-specific mortality analyses. Comparisons were also conducted according to implant characteristics.
  
  
  RESULTS
  Compared with women with other cosmetic surgery, those with cosmetic breast implants had at later stage breast cancer diagnosis (OR of having stage III/IV vs. stage I at diagnosis: 3.04, 95% confidence interval (CI): 1.81-5.10; P < 0.001). A nonstatistically significant increase in breast cancer-specific mortality rate for women with breast implants relative to surgical controls was observed (HR = 1.32, 95% CI: 0.94-1.83, P = 0.11). No statistically significant differences in stage and breast cancer mortality were observed according to implant characteristics.
  
  
  CONCLUSIONS
  At diagnosis, breast cancers tended to be at more advanced stages among women with cosmetic breast implants. Breast cancer-specific survival was lower in these women although the reduction did not reach statistical significance.
  
  
  CONCLUSIONS
  Further investigations of the effect of breast implants on breast cancer prognosis are warranted.
authors: Unité de Recherche en Santé des Populations, URESP, Centre de recherche FRSQ du Centre hospitalier affilié universitaire de Québec and Laval University, Quebec City, Quebec, Canada. elavigne@uresp.ulaval.ca
authors: Eric
authors: E
authors: Lavigne
authors: Eric J
authors: EJ
authors: Holowaty
authors: Sai Yi
authors: SY
authors: Pan
authors: Lin
authors: L
authors: Xie
authors: Paul J
authors: PJ
authors: Villeneuve
authors: Howard
authors: H
authors: Morrison
authors: Jacques
authors: J
authors: Brisson
mesh_terms: D000328:Adult; D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models