Breast Augmentation Disorders

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

• Women with symptoms of autoimmune illnesses often undergo implant removal, but no benefit has been shown

• 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