title: Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies.
abstract: OBJECTIVE
  To evaluate whether the stage distribution among women diagnosed as having breast cancer differs between those who have received breast implants for cosmetic purposes and those with no implants and to evaluate whether cosmetic breast augmentation before the detection of breast cancer is a predictor of post-diagnosis survival.
  
  
  METHODS
  Systematic review of observational studies with two meta-analyses.
  
  
  METHODS
  Systematic search of the literature published before September 2012 conducted in Medline, Embase, Global health, CINAHL, IPAB, and PsycINFO.
  
  
  METHODS
  Eligible publications were those that included women diagnosed as having breast cancer and who had had augmentation mammaplasty for cosmetic purposes.
  
  
  RESULTS
  The overall odds ratio of the first meta-analysis based on 12 studies was 1.26 (95% confidence interval 0.99 to 1.60; P=0.058; I(2)=35.6%) for a non-localized stage of breast cancer at diagnosis comparing women with implants who had breast cancer and women without implants who had breast cancer. The second meta-analysis, based on five studies, evaluated the relation between cosmetic breast implantation and survival. This meta-analysis showed reduced survival after breast cancer among women who had implants compared with those who did not (overall hazard ratio for breast cancer specific mortality 1.38, 95% confidence interval 1.08 to 1.75).
  
  
  CONCLUSIONS
  The research published to date suggests that cosmetic breast augmentation adversely affects the survival of women who are subsequently diagnosed as having breast cancer. These findings should be interpreted with caution, as some studies included in the meta-analysis on survival did not adjust for potential confounders. Further investigations are warranted regarding diagnosis and prognosis of breast cancer among women with breast implants.
authors: Centre de Recherche du CHU de Québec, Faculté de Médecine, Université Laval, Quebec, QC, 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: Paul J
authors: PJ
authors: Villeneuve
authors: Kenneth C
authors: KC
authors: Johnson
authors: Dean A
authors: DA
authors: Fergusson
authors: Howard
authors: H
authors: Morrison
authors: Jacques
authors: J
authors: Brisson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019928:Breast Implantation / Q000706:statistics & numerical data*; D018427:Breast Implants / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D006801:Humans; D008875:Middle Aged; D013518:Surgery, Plastic / Q000706:statistics & numerical data*; D015996:Survival Rate