Breast augmentation is the second most commonly performed aesthetic surgery procedure globally. It is sought by women to improve their body proportions, thereby improving their self confidence and quality of life. Though breast augmentation can be done using implants or an individual’s own fat; the former is the most common method of breast augmentation.The latest data of ISAPS (International Society of Aesthetic Plastic Surgery) for year 2023 published last month states that 18,92,777 women underwent breast augmentation globally using silicone implants. Out of these approximately 47,690 breast augmentations were performed in India (data until 30 June 2023).
A common question that I encounter from all my patients undergoing breast implants is that , “Does breast augmentation using implants increase the risk of breast cancer?” The answer to that question is a firm NO as there are no literature about the data or research to suggest this as of yet. The common breast cancers, ductal carcinoma or lobular carcinoma that arise in the breast parenchyma have not been seen in patients with breast implants, though silicone implants have been around for more than 6 decades now. Even from the initial decade, when breast implants were new and prone to complications like rupture and leaking of silicone; there have been no case reports of them causing breast cancer. These days we use highly evolved 5th generation silicone implants that do not suffer from problems like rupture or leaks that were seen in the initial days.
However, there are few extremely rare and unique cancers that have been reported in the “capsule” of breast implants. Capsule formation is the body’s normal response to the presence of any foreign body and it is a fibrous tissue structure that develops all around the implant after the surgery. One of these capsule cancers is BIA- ALCL or the breast implant associated – anaplastic large cell lymphoma that has been reported in just 1264 women across the globe while breast implants have been in existence for more than six decades and millions of women have successfully undergone breast implants and leading happy and confident lives. BIA-ALCL is more commonly reported with textured implants than smooth implants. It is not a breast cancer and is classified by the World Health Organisation (WHO) as T cell lymphoma/Non Hodgkin’s lymphoma (a cancer of the immune system). The first reported case of this cancer was in 2011. The symptoms of BIA-ALCL are pain, persistent swelling or a lump around the breast implants that may happen years after the implant has settled in the body. Another extremely rare cancer reported in the capsule of breast implants is the squamous cell carcinoma. A total of 19 cases of this cancer have been reported till 8 March 2023. Other even rarer cancers reported in the capsule of breast implants are rare lymphomas (other than BIA-ALCL). None of the cancers described above are classified as breast cancers.The treatment of these “implant capsule cancers” involves removing the implant, its capsule and surrounding tissues. Rarely chemotherapy or radiotherapy may be needed.However, one may note that the incidence of these implant capsule cancers is extremely low. Just like the incidence of airplane crashes are very low despite thousands of aircrafts flying every day; same way millions of women have satisfactorily undergone breast implants with only a rare few developing cancers in their breast implant capsule. I also take this opportunity to inform women who are contemplating breast implants; that breast implants have not been reported to be causing connective tissue disorders, problems in breast-feeding or raised silicone levels in the babies as compared to women who have not had any implants.
