title: A population-based analysis of secondary malignancies in breast cancer patients receiving breast reconstruction.
abstract: There is an ongoing debate about the relationship between breast implants and secondary malignancies.
  
  
  
  Breast cancer patients undergoing surgical reconstruction after mastectomy by either implants or autologous flap were identified in the Surveillance, Epidemiology and End Results registry between 1998 and 2002. The occurrence of secondary malignancies at least 1 year after diagnosis was compared between breast reconstruction with implants vs autologous flap.
  
  
  
  Of 7955 women, 3727 underwent reconstruction using implants and 4228 using autologous flap. The incidence of secondary tumours was similar in both the groups (hazards ratio (HR)=1.02, 95% confidence interval (CI): 0.82-1.26, P=0.880). For lung cancer, a significantly increased risk for implants (HR=2.51, 95% CI: 1.28-4.95, P=0.005) was observed.
  
  
  
  Except for lung cancer, no association between implants and secondary malignancies including lymphomas was observed.
authors.affiliation: Department of Surgery, Cantonal Hospital, 9007 St Gallen, Switzerland.|Institute of Medical Biometry and Informatics, University of Heidelberg, 69120 Heidelberg Germany.
authors.forename: Rene
authors.initials: R
authors.lastname: Warschkow
authors.affiliation: Department of Medical Oncology and Hematology, Cantonal Hospital, 9007 St Gallen, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Cerny
authors.affiliation: Department of Surgery, Cantonal Hospital, 9007 St Gallen, Switzerland.
authors.forename: Bruno M
authors.initials: BM
authors.lastname: Schmied
authors.affiliation: Department of Medical Oncology and Hematology, Cantonal Hospital, 9007 St Gallen, Switzerland.|Department of Visceral Surgery and Medicine, University of Berne, Berne, Switzerland.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Güller
authors.affiliation: Breast Center, Cantonal Hospital, 9007 St Gallen, Switzerland.
authors.forename: Beat
authors.initials: B
authors.lastname: Thuerlimann
authors.affiliation: Department of Medical Oncology and Hematology, Cantonal Hospital, 9007 St Gallen, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Joerger
mesh_terms: D000328:Adult; D000368:Aged; D018427:Breast Implants / Q000009:adverse effects; D001943:Breast Neoplasms / Q000209:etiology / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D016462:Mammaplasty / Q000009:adverse effects*; D008408:Mastectomy / Q000009:adverse effects; D008875:Middle Aged; D016016:Proportional Hazards Models; D013524:Surgical Flaps / Q000473:pathology / Q000601:surgery