Breast implants can be inserted behind the gland or behind the muscle as part of cosmetic or reconstructive breast surgery, or as part of gender reassignment surgery.
Breast implants may be filled with sterile salt water or silicone gel, in a shell that may have either a smooth, slightly textured (micro-textured), or highly textured (macro-textured) surface. In Quebec, an estimated 145,000 women have breast implants, all types combined.
But what is the impact of these implants on breast health? Here are the answers to the questions most frequently asked by people who have or are considering breast implants.
Does having breast implants increase my risk of breast cancer?
No link has been found between breast implants and the development of adenocarcinoma, which accounts for 95% of breast cancer cases.
However, if you have textured breast implant(s), there is an increased but minimal risk (between 1/3,817 and 1/30,000 according to Health Canada) of developing anaplastic large cell lymphoma (ALCL). ALCL is not breast cancer, but rather a rare form of cancer affecting the immune system, which can develop next to the implant.
As of 2019, certain models of textured breast implants can no longer be sold or imported into Canada and others have been removed from the Canadian market.
Although to date, no link has been made between other types of cancer or other types of implants, the link between the development of any type of cancer and any type of implant is under close surveillance.
I have had breast cancer. Am I more likely to develop this type of lymphoma?
If you have textured breast implants and you have had breast cancer, you are no more likely to develop ALCL than someone without a history of the disease.
How do breast implants affect breast observation?
Contrary to what one might think, having breast implants does not interfere with breast observation; it is done in the same way as for a person without implants. The important thing is to know your breasts in their current state in order to quickly detect any new, unusual, and persistent changes.
ALCL can present signs similar to those caused by breast cancer. It is therefore very important to perform regular breast observation and consult a health professional promptly if unusual changes appear.
Are there any special recommendations for people with breast implants?
In addition to regular breast observation, Health Canada recommends that people with breast implants have systematic follow-ups with a health professional. For example, you can ask a doctor how often you should be seen, given your situation.
Are there any risks to having a mammogram with breast implants?
In terms of mammography (breast x-rays), there is no issue with having breast implants, but it is important to mention this before the examination is done. Medical imaging technologists are trained to apply minimal compression with the machine to avoid rupturing the implant.
Do breast implants interfere with the interpretation of mammogram results?
If you have implants, it may take longer to perform the mammogram, so it is important to mention this when you make your appointment. To ensure that all the tissues surrounding the implant are exposed as much as possible, technologists take additional shots using specific techniques.
Despite these techniques, there may be areas of the breast that are hidden by the implant that will remain difficult for the radiologist to assess. If part of the breast tissue is not visible, or in case of doubt, you may be asked to undergo additional tests.
Can a mammogram be performed when an implant is ruptured?
If you have a ruptured implant, other tests may be offered prior to having the implant removed or replaced.
Are there specific screening recommendations for people with breast implants?
People with breast implants can have screening mammograms and participate in the Québec Breast Cancer Screening Program (PQDCS). They should follow the same breast cancer screening recommendations as people without implants.
If I am diagnosed with breast cancer, will having breast implants interfere with treatments?
Having breast implants does not interfere with breast cancer treatments. Expansion prostheses (placed during multi-stage reconstruction surgery) and permanent breast implants can be irradiated during radiation treatments.
However, if you have breast implants, it may be necessary to remove them during surgery or radiation. Also, if you are planning to have reconstruction with implants and need radiation, you may be advised to have surgery immediately or at a later date. Your healthcare team will consider several factors in order to tell you which procedure is most likely to provide the best results and be better tolerated.
What should I do if I am thinking about getting breast implants?
If you are thinking about getting breast implants, you can learn about their risks and benefits and discuss them with a healthcare professional or a member of your healthcare team.
To learn more about breast reconstruction and alternatives to breast implants, you can also read our blog post on the subject here.