Monday, June 29, 2009

Breast Implants and Lymphoma Risk

Updated 3/2017-- all links (except to my own posts) removed as many no longer active. and it was easier than checking each one.

Yes, I’m behind in my journal reading. This article was published in the March issue of the Plastic and Reconstructive Surgery Journal. The article is the summary of a literature review using PubMed to review the evidence from all epidemiologic cohort studies of cancer incidence among women with cosmetic breast implants that include results on the incidence of non-Hodgkin's lymphoma, with specific attention to lymphomas arising in the breast.
The review was prompted by the article from The Netherlands (second reference below) which suggested an association of breast implants with anaplastic large T-cell lymphoma.
Primary breast lymphoma is a rare malignancy. Most of them are of B-cell origin. It is important for anecdotal reports not to alarm providers or patients. This review article found only five long-term cohort studies which had evaluated the incidence of non-Hodgkin's lymphoma following cosmetic breast augmentation surgery.
The authors looked at each study and came to the following conclusion:
The association between cosmetic silicone breast implants and non-Hodgkin's lymphoma has been examined in a number of long-term cohort and surveillance studies, based on large numbers of women with virtually complete follow-up substantially longer than the 17-year study period presented in the Dutch case-control study.
In the only cancer incidence study to include women followed for at least 25 years after implantation, including 3336 women followed for 15 years or more and 827 followed for at least 25 years, no significant excess of non-Hodgkin's lymphoma was observed overall and not one primary lymphoma of the breast was observed.
Moreover, the largest study to date, with cancer surveillance up to 24 years, actually reported a reduced incidence of total non-Hodgkin's lymphoma among almost 25,000 Canadian women with cosmetic breast implants.
Based on the epidemiologic studies published to date, there is no evidence of an excess of non-Hodgkin's lymphoma incidence overall among women with cosmetic silicone-filled breast implants.
Breast Implants and Lymphoma Risk: A Review of the Epidemiologic Evidence through 2008; Plastic & Reconstructive Surgery. 123(3):790-793, March 2009; Lipworth, Loren Sc.D.; Tarone, Robert E. Ph.D.; McLaughlin, Joseph K. Ph.D. (subscription required)
Anaplastic large-cell lymphoma in women with breast implants; JAMA. 2008;300:2030-2035; De Jong D, Vasmel WLE, de Boer JP, et al. (subscription required)

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