title: Breast implants and the risk of breast cancer: a meta-analysis of cohort studies.
abstract: BACKGROUND
  The popularity of cosmetic breast augmentation and the incidence of breast cancer have been increasing worldwide. It has been hypothesized that the risk of breast cancer may be greater among patients who have undergone cosmetic breast implantation.
  
  
  OBJECTIVE
  The authors performed a meta-analysis of the available literature on the risk of breast cancer among women with cosmetic breast implants.
  
  
  METHODS
  The study was designed as a meta-analysis of observational studies. A systematic search of the English literature (published by August 28, 2013) was conducted in PubMed and EMBASE. Eligible reports were those that included relative risk (RR; the increased or decreased risk of breast cancer associated with breast implants) or the standardized incidence ratio (SIR) of the observed number of cases of breast cancer to the expected number of cases among patients that previously underwent cosmetic breast augmentation.
  
  
  RESULTS
  Seventeen studies representing 7 cohorts were selected. Some of these were follow-up reports of previously published studies; in such cases, only the most recent reports were included in the meta-analysis. Summary SIR and RR rates and the corresponding 95% confidence intervals (CIs) were calculated with a random-effects (SIR) or fixed-effects (RR) model. The overall SIR estimate was 0.69 (95% CI, 0.56-0.85), and the overall RR, based on 4 studies, was 0.63 (95% CI, 0.56-0.71).
  
  
  CONCLUSIONS
  Finding of this meta-analysis suggest that women who have undergone cosmetic breast implantation do not have an increased risk of breast cancer.
authors.affiliation: Dr Noels is a researcher and Dr Lapid is a plastic surgeon in the Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. Dr Lindeman is a senior researcher in the Department of Vascular Surgery, and Dr Bastiaannet is an epidemiologist and senior researcher in the Department of Surgery and Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Eline C
authors.initials: EC
authors.lastname: Noels
authors.affiliation: Dr Noels is a researcher and Dr Lapid is a plastic surgeon in the Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. Dr Lindeman is a senior researcher in the Department of Vascular Surgery, and Dr Bastiaannet is an epidemiologist and senior researcher in the Department of Surgery and Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Oren
authors.initials: O
authors.lastname: Lapid
authors.affiliation: Dr Noels is a researcher and Dr Lapid is a plastic surgeon in the Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. Dr Lindeman is a senior researcher in the Department of Vascular Surgery, and Dr Bastiaannet is an epidemiologist and senior researcher in the Department of Surgery and Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Jan H N
authors.initials: JH
authors.lastname: Lindeman
authors.affiliation: Dr Noels is a researcher and Dr Lapid is a plastic surgeon in the Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. Dr Lindeman is a senior researcher in the Department of Vascular Surgery, and Dr Bastiaannet is an epidemiologist and senior researcher in the Department of Surgery and Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Bastiaannet
mesh_terms: D019928:Breast Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D064887:Observational Studies as Topic; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors