Breast Cancer Patients More Satisfied with Silicone Implants
by Laurie Wertich 9/2019
Women diagnosed with breast cancer who have undergone mastectomy and breast reconstruction report somewhat higher satisfaction with silicone implants than with saline implants. These findings were published in CANCER, the journal of the American Cancer Society.
Following mastectomy, women undergoing reconstruction with implants may choose between implants that are filled with saline (salt water) or silicone gel. Both types of implants are approved by the U.S. Food and Drug Administration. While safety and effectiveness have been and continue to be important concerns about implants, patient satisfaction and quality of life following reconstruction are also significant considerations.
To compare patient satisfaction among women who received silicone implants with those who received saline implants, researchers evaluated questionnaires completed by 472 women. One hundred seventy-six of these women had received silicone implants, and 306 had received saline implants.Women who had received silicone implants tended to report greater satisfaction with their reconstructed breasts than those who had received saline implants. Women in both groups who had received radiation therapy following their mastectomy were less satisfied with their reconstruction.
As well, all women reported reduced satisfaction with their reconstruction over time.The researchers concluded that women who received silicone implants tended to be more satisfied than those who received saline implants. They add, however, that patient satisfaction with reconstruction following mastectomy is generally high and that variables in addition to implant type affect satisfaction. Patients may therefore be confident that good outcomes are possible with either type of implant.
Brachytherapy Provides Good Cosmetic Outcomes Among Women with Breast Implants
For women with early-stage breast cancer a lumpectomy followed by brachytherapy (placement of radioactive “seeds” in the breast) appears to be effective and to provide better cosmetic outcomes than lumpectomy followed by whole-breast radiation therapy.
For women with breast implants, whole-breast radiation therapy can result in the formation of scar tissue around the breast implant (a condition known as capsular contracture). This can be painful and can also distort the appearance of the breast. As a result, women with breast implants and breast cancer often undergo mastectomy with implant exchange rather than breast-conserving therapy. Because brachytherapy provides radiation to a more targeted area of the breast, it may reduce the risk of capsular contraction and allow more women with breast implants to undergo breast-conserving therapy.
To evaluate the effects of lumpectomy followed by brachytherapy, researchers conducted a study among 65 women with small, early-stage breast cancers and breast implants. After lumpectomy, the women were treated with brachytherapy in two doses per day over a five-day period.
- All of the study participants had good or excellent cosmetic outcomes.
- None of the study participants experienced capsular contracture.
These results suggest that lumpectomy followed by brachytherapy is effective and associated with good cosmetic outcomes in women with breast implants. Women with breast implants and early-stage breast cancer may wish to talk with their doctor about the range of cancer treatment options that are available.(2,3)
- McCarthy CM, Klassen AF, Stefan J. Cano SJ, et al. Patient satisfaction with post mastectomy breast reconstruction: a comparison of saline and silicone implants. Cancer [early online publication]. November 8, 2010.
- Poggi MM, Danforth DN, Sciuto LC, et al. Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial. *Cancer.*2003;98(4): 697-702.
- Kuske R. Breast brachytherapy improves cosmetic outcome and reduces the risk of capsular contracture in breast conservation therapy for women with breast cancer in the presence of augmentation mammoplasty. Presented at the 2008 annual meeting of the Radiological Society of North America. Presentation SSC19-02.