Safety of Silicone Breast Implants (1999) / Chapter Skim
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9 Silicone Breast Implants and Cancer
9 Silicone Breast Implants and Cancer
Pages 233-241
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From page 233... ...
These questions include whether there has been an increase in primary or recurrent carcinoma of the breast associated with silicone breast implants, whether there has been an increase in breast malignancies other than primary carcinoma of the breast associated with implants, and whether there has been an increase in non-breast malignancies in women with implants, for example, solid tumors (carcinomas) of other organs, sarcoma, lymphoma, or myeloma.
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From page 234... ...
In 1997, Brinton and Brown reviewed many studies relating to the carcinogenicity of silicone breast implants and concluded that these studies found no association of breast implants with breast carcinoma, although they noted that some potential outcomes, such as non-breast malignancies and breast sarcomas, or factors such as life-style, latencies, and others were not adequately addressed.
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From page 235... ...
The average follow-up of the implant cohort was 10.2 years, and the average length of time from breast augmentation to the diagnosis of breast cancer was 7.5 years. The standard incidence ratio was 0.476, significantly lower than expected (p < 0.01)
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From page 236... ...
The Danish study, first reported by letter (McLaughlin et al., 1994) , found standardized incidence ratios less than one for breast cancer and for all cancers; the results were reported in more detail by Friis et al.
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From page 237... ...
The committee concludes, therefore, that there is limited evidence that silicone breast implants are not associated with non-breast cancers. A number of investigators have studied recurrence of cancer or death due to breast cancer in patients with silicone implants for breast reconstruction after mastectomy.
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From page 238... ...
These data present a consistent picture that implants do not increase breast cancer recurrence rates or decrease survival rates in patients after reconstruction with implants. BREAST SARCOMAS AND OTHER TUMORS Because silicone solid-state carcinogenesis results in sarcomas in susceptible rodents, the prevalence of breast sarcomas in women has been explored.
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From page 239... ...
This evidence consistently fails to support an increase in breast sarcoma associated with silicone breast implants, although analysis of the national data would not be expected to detect small increases in breast sarcoma because of the rarity of that condition. Another rare fibrous tumor that can infiltrate extensively into surrounding structures but does not metastasize is classified by the term "dermoid." Rosen and Ernsberger (1989)
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From page 240... ...
(1996a) reviewed immunoglobulin levels in 630 symptomatic women with silicone breast implants of 14 years' mean duration and found elevated immunoglobulins in 23%.
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From page 241... ...
CONCLUSIONS There is a consistent, substantial, long-term base of scientific evidence bearing on the experimental carcinogenicity and clinical breast or other cancer experience with silicone and silicone breast implants. Based on its review of this evidence, the committee concludes that the available evidence does not support an association of silicone or silicone breast implants with experimental carcinogenesis (other than rodent solid-state carcinogenesis)
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