隆乳术后乳腺癌（美国）

Breast cancer following augmentation mammoplasty (United States).

作者信息

Brinton L A, Lubin J H, Burich M C, Colton T, Brown S L, Hoover R N

机构信息

Epidemiology and Biostatistics Program, National Cancer Institute, Bethesda, MD, USA.

出版信息

Cancer Causes Control. 2000 Oct;11(9):819-27. doi: 10.1023/a:1008941110816.

DOI:10.1023/a:1008941110816

PMID:11075871

Abstract

OBJECTIVE

Although clinical reports have raised concern that breast implants may either increase the risk of breast cancer or delay its diagnosis, epidemiologic studies have generally shown implant recipients to be at a reduced risk of subsequent breast cancer. A large retrospective cohort study was undertaken to clarify effects of cosmetic breast implantation.

METHODS

Medical records of 13,488 women receiving cosmetic implants at 18 plastic surgery practices and a group of 3936 patients who received other types of plastic surgery at the same practices were reviewed and information abstracted. Questionnaires were sent to all subjects located as alive, with 71% being completed. Attempts were made to obtain medical verification for all reported cancers and to obtain death certificates for deceased subjects.

RESULTS

A total of 136 breast cancers were observed among the breast implant patients. External analyses, using general population rates from the Surveillance, Epidemiology and End Results (SEER) program, resulted in 152.2 cases expected and a standardized incidence ratio (SIR) of 0.9 (95% CI 0.8-1.1). A comparable SIR was found for the other plastic surgery patients (SIR =1.0, 95% CI 0.7-1.2). Internal analyses, directly comparing the implant patients with the other plastic surgery patients, showed a RR of 0.8 (95% CI 0.6-1.1). In neither the external nor internal analyses was there any systematic variation in risk by age or calendar year of initial implant. Risk also did not vary by years of follow-up or by type of implant. Risk was not affected by exclusion of patients who received their implants following surgery for benign breast disease. Although breast tumors tended to be detected at a somewhat later stage among the breast implant than the comparison patients, the difference was not statistically significant, nor was there any significant difference in breast cancer mortality between the two groups.

CONCLUSIONS

Breast implants do not appear to alter the risk of subsequent breast cancer.

摘要

目的

尽管临床报告引发了人们对隆胸植入物可能增加患乳腺癌风险或延迟其诊断的担忧，但流行病学研究总体表明，接受植入物的患者患后续乳腺癌的风险降低。开展了一项大型回顾性队列研究以阐明美容性隆胸植入的影响。

方法

回顾了18家整形手术机构中13488名接受美容植入物的女性以及在同一机构接受其他类型整形手术的3936名患者的病历，并提取了相关信息。向所有在世的受试者发送了问卷，71%的问卷得到了回复。试图对所有报告的癌症进行医学核实，并为已故受试者获取死亡证明。

结果

在隆胸植入物患者中总共观察到136例乳腺癌。使用监测、流行病学和最终结果（SEER）计划的一般人群发病率进行外部分析，预期病例数为152.2例，标准化发病率（SIR）为0.9（95%可信区间0.8 - 1.1）。在其他整形手术患者中发现了类似的SIR（SIR = 1.0，95%可信区间0.7 - 1.2）。直接将植入物患者与其他整形手术患者进行比较的内部分析显示相对危险度（RR）为0.8（95%可信区间0.6 - 1.1）。在外部分析和内部分析中，初始植入时的年龄或日历年份均未导致风险出现任何系统性变化。风险也不因随访年限或植入物类型而有所不同。排除因良性乳腺疾病手术后接受植入物的患者后，风险不受影响。尽管隆胸植入物患者中的乳腺肿瘤往往比对照患者在稍晚阶段被发现，但差异无统计学意义，两组之间的乳腺癌死亡率也无显著差异。