Stage of breast cancer at diagnosis among women with cosmetic breast implants.

Breast implants are widely used for both reconstructive and cosmetic purposes. There is no evidence that breast implants increase the risk of breast cancer (Brinton et al, 2000b; Mellemkjaer et al, 2000). On the contrary, several reports document that women with cosmetic breast implants seem to be at a lower risk of developing breast cancer (Berkel et al, 1992; Deapen et al, 1997; McLaughlin et al, 1998; Hoshaw et al, 2001). However, the issue of potential delay in breast cancer diagnosis in the augmented breast has been raised, since breast implants are radiopaque and this influences the sensitivity of mammography (Eklund et al, 1988; Hayes et al, 1988; Silverstein et al, 1992). Clinical reports have suggested a possible delay and difficulties in the diagnosis of breast cancer (Leibman and Kruse, 1990; Silverstein et al, 1990a; Carlson et al, 1993; Fajardo et al, 1995), but most epidemiological studies have not supported a delay in diagnosis or impaired survival among women with breast implants (Birdsell et al, 1993; Deapen et al, 2000). We identified all subsequent incident cases of invasive breast cancer within a large cohort of women with breast implants. The stage distribution at diagnosis, tumour characteristics and overall survival of cohort women with breast cancer were compared with those of a random sample of women with breast cancer from the general population matched to the cohort on age and year of diagnosis. This study entails more detailed and uniformly collected information about tumour stage and characteristics than previous studies.