title: Current Trends in the Oncologic and Surgical Managements of Breast Cancer in Women with Implants: Incidence, Diagnosis, and Treatment.
abstract: Breast augmentation is the most common cosmetic surgery in the United States, and thousands of augmented patients develop breast cancer each year. The possible effects of implants on cancer incidence, diagnosis, and treatment usually generate a disarming confusion. The present paper represents an update of the more recent oncologic and surgical strategies, aiming to support plastic and general surgeons in such challenging aspects. Several aspects of breast cancer management in augmented women are investigated, including (1) risk estimation and cancer characteristics, stage at diagnosis, and prognosis; (2) cancer diagnosis with clinical examination, mammography, ultrasound, and magnetic resonance imaging; (3) cancer treatment including breast conservation, intraoperative radiotherapy, sentinel node biopsy and mastectomy, and reconstruction. A brief resume of recommendations and conclusions is suggested, elucidating correct trends in the oncologic management of augmented patients and refusing well-established misconceptions: (1) breast augmentation does not increase the risk of breast cancer incidence, and it does not influence the prognosis; (2) possible risks exist in cancer detection due to technical difficulties; (3) sentinel lymph node detection is feasible; (4) intraoperative radiotherapy represents a good chance for conserving treatment; (5) immediate reconstruction with submuscular-subfascial implants is the most common procedure after mastectomy, and biological substitutes could support this procedure. Breast clinicians should be alerted because of high expectations of this subgroup of patients, accustomed to emphasize the aesthetic result.
  
  
  METHODS
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authors: Department of Surgery, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors: Paolo
authors: P
authors: Veronesi
authors: Department of Plastic and Reconstructive Surgery, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy. francesca.delorenzi@ieo.it.
authors: Francesca
authors: F
authors: De Lorenzi
authors: Department of Plastic and Reconstructive Surgery, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors: Pietro
authors: P
authors: Loschi
authors: Department of Plastic and Reconstructive Surgery, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors: Mario
authors: M
authors: Rietjens
authors: Department of Surgery, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy.
authors: Umberto
authors: U
authors: Veronesi
mesh_terms: D018427:Breast Implants; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods / Q000639:trends; D008408:Mastectomy / Q000379:methods / Q000639:trends; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy
keywords: Breast augmentation; Breast cancer; Implants and cancer; Intraoperative radiotherapy; Women with implant