Findings from a recently published study demonstrated that only a small percentage of women — all with breast cancer — who received silicone breast implants underwent the recommended screening to assess for potential ruptures.
Although the Food and Drug Administration (FDA) has recommended that women who receive silicone breast implants — whether for cosmetic reasons or following surgery for breast cancer — undergo routine screening to look for potential rupture of the implant, recently published findings showed that many patients failed to stick to the follow-up schedule.
Furthermore, the results identified that many of the patients reported being unaware of the importance of undergoing routine screening for possible rupture of their silicone breast implants.
“So many women … have had breast cancer and undergo breast reconstruction with (silicone) implants … (and) although implants have been around for many years and are recognized as being safe, it’s important to be aware they do require some routine surveillance and maintenance,” said Dr. Libby Copeland-Halperin, a plastic, reconstructive and cosmetic surgeon at a private practice in New York City, in an interview with CURE®.
In 2006, the FDA recommended that patients who received silicone breast implants undergo routine MRI scans to detect possible implant rupture three years after surgery and every two years thereafter. However, it appears that not many patients adhered to this.
Copeland-Halperin was the lead author on a study that was published in the American Society of Plastic Surgeons journal, which demonstrated that out of 109 patients with silicone breast implants, 15.6% underwent an MRI after initial implant surgery. But only 5.9% continued to follow the recommended timeline.
Copeland-Halperin noted that many patients are told about these recommendations at the time of surgery, but explained that other care might get in the way of them following through.
“Especially patients with cancer that have a lot going on; they’re seeing a lot of different doctors, they’re focusing on a lot of different elements of their care,” she explained. “What we found was that patients weren’t always aware of the recommendation, even if it had been provided to them, even if it had been discussed with them. It’s just that there’s so much else going on in their care that it’s not necessarily something that they’re always aware of.”
Some other reasons patients reported not adhering to FDA recommendations included that they were not able to access MRI’s due to insurance or other factors, they thought they were fine and “they didn’t like MRI” testing.
What Patients Should Know
Copeland-Halperin reassured patients who haven’t been following the recommended screening guidelines not to worry but stated that they should start discussing it with their providers.
“The first thing to remember is this is not something that people should panic about if they haven’t gotten their screening,” she said. “It’s not something that they need to worry about right away and rush to the emergency room. But it is something they should talk to their surgeon about and make sure they schedule their appropriate surveillance.”
It is important to note that the FDA guidelines have since changed since this study was first conducted. It is now recommended that patients with silicone breast implants undergo an ultrasound or MRI five to six years after initial surgery, and every two to three years thereafter.
The surveillance is important because if an implant does rupture, a patient may not know because they are unlikely to experience symptoms, according to Copeland-Halperin. But the ultrasound or MRI can detect it, allowing providers to treat it before symptoms occur.
“It’s important to remember that implants have been around for a long time — and this is not to say they aren’t safe, we wouldn’t be doing procedures if we didn’t think they were safe — but they do require routine maintenance and surveillance,” she concluded.
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