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Key Features

  • At least 4 million American women have had breast implants

  • No increase in autoimmune disease associated with silicone gel implants

  • No increased risk of breast cancer associated with implants, but cancer can develop in implant patients

  • Rarely, lymphoma of the breast with silicone implants has been reported

Clinical Findings

  • Capsule contraction or scarring around the implant occurs in 15–25% of patients, leading to a firmness and distortion of the breast that can be painful

  • Implant rupture may occur in as many as 5–10% of women, and bleeding of gel through the capsule is even more common

Diagnosis

  • Breast cancer may be more difficult to diagnose because mammography is less able to detect early lesions if implants are present

  • However, after a woman who had mastectomy undergoes breast reconstruction with implants, local recurrence of cancer is usually cutaneous or subcutaneous and is easily detected by palpation

Treatment

  • Women should consider removal of implants if they have significant pain or symptoms of autoimmune illness

  • If a cancer develops, it should be treated in the same manner as in women without implants

  • Radiotherapy of the augmented breast often results in marked capsular contracture

  • Adjuvant therapy should be given for same indications as for women without implants

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