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Breast implants OK with lump surgery

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DENVER, Oct 17, 2005 (UPI via COMTEX) -- Women who have breast implants can safely undergo breast-cancer surgery without having to discard them, new research suggests.

Previous small studies had indicated breast-conserving surgery -- the removal of just the cancerous tissue -- was impractical in women with implants, because it required follow-up radiation that could cause disfiguring changes in tissue and in the implant.

Now, newer surgical techniques, imaging and radiation-delivery techniques have changed that, said Dr. Rosalyn Morrell, a resident in radiation oncology at Chandler Regional Hospital in Arizona.

"The fact that a woman has a breast implant does not appear to impact outcomes if she wants to continue breast-conserving surgery," said Morrell, who analyzed outcomes among women with breast implants treated at Mayo Clinic hospitals in Arizona, Florida and Minnesota.

Morrell presented her findings at the annual meeting of the American Society of Therapeutic Radiation and Oncology.

She said about 300,000 breast-augmentation procedures were performed in the United States in 2004, and "the numbers of operations are increasing."

Morrell and colleagues examined retrospectively 26 cases in which women with breast implants were treated for early breast cancer with lumpectomy and without removal of the original implant. The cases included women treated between 1994 and 2004.

"We found that 22 of the women had good results, achieving a (score of) 1 or 2 on the Baker Classification," Morrell told United Press International. In the Baker Classification, 1 means the breast looks and feels normal after surgery, while 2 also is considered a cosmetically acceptable outcome. Scores of 3 or 4 usually are considered unacceptable.

The other four women who scored 3 or 4 on the Baker scale underwent removal of their original implant and had subsequent cosmetic surgery to create a more normal-looking breast, she said.

The study could help maintain the increasing rate of breast-augmentation surgery in the United States, suggested Dr. Gregory Swanson, associate professor of radiation oncology and urology at the University of Texas Health Science Center in San Antonio.

"There have been a number of questions about whether implants interfere with imaging the breast when a woman has a mammogram performed," Swanson told UPI, "so I think it is appropriate that a plastic surgeon discusses breast-cancer issues with patients before augmentation surgery."

With this new information, he said, plastic surgeons could relieve concerns their patients might have about breast cancer down the road and how implants could impact that treatment.

"The surgeon could say, 'We have evidence that the implant won't be a problem,'" he said.

Morrell said that in general women who are having implants are not that concerned about breast cancer, so she discounted the impact the study might have on women considering the procedure.

In her study, Morrell found that after an average of three years following breast-conserving surgery and radiation, all the women whose records she scrutinized remained breast-cancer free.

She said that as more and more women undergo breast-augmentation surgery, the odds were more women with implants would present for lumpectomies. She said current statistics indicate breast implants do not increase the likelihood of contracting breast cancer.

Her analysis of the cases indicated the only significant risk factor for breast cancer in the group of women studied was age.

In past years, Swanson said, when a woman with an implant would be diagnosed with breast cancer, doctors routinely would remove the implant as part of the surgical treatment.

"Then we had a woman who said she didn't want the implant removed, and asked us to proceed without taking it out," Swanson explained. "We did, and she did well. We have now done a handful of women similarly without any problems."

Swanson, who was not part of the Mayo study, said his overall experience has been similar to Morrell's and suggested women with early-stage breast cancer who have implants should have no particular problem preserving the implants.

Morrell said advances in surgical techniques, imaging and radiation technology make it more feasible to perform breast-conservation surgery with radiation -- the standard of care for the procedure -- without adversely impacting how the implant feels in the breast.

"Past research, which showed only a 50 percent satisfactory outcome, was based on a small sample of patients and older radiation techniques," Morrell said. "Therefore, we investigated a larger group of women treated with radiation, using newer techniques that refuted the reports of poor cosmetic outcome among patients."

Morrell said the treatment probably will be "favored by the population of patients who were interested enough in the appearance of their breasts to have undergone prior augmentation surgery."

Edward Susman covers medical research for UPI. E-mail:


Copyright 2005 by United Press International

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