Deapen Dennis
Los Angeles, Calif. From the Department of Preventive Medicine, Keck School of Medicine, University of Southern California.
Plast Reconstr Surg. 2007 Dec;120(7 Suppl 1):70S-80S. doi: 10.1097/01.prs.0000286577.70026.5d.
Soon after breast implants were commercially introduced over 30 years ago, questions about potential carcinogenicity were raised. Animal experiments dating back to the mid-twentieth century demonstrated that foreign body implantation of many materials, including silicone, can induce sarcomas. Indeed, female breast cancer incidence rates in the United States have increased substantially over that period. Of the several published studies from various countries that have formally investigated the risk of breast cancer among augmentation mammaplasty patients, none show any evidence of increased risk. In fact, most find lower than expected risk, some with statistically significant reductions. Similarly, breast cancer mortality among these patients is generally found to be below that expected of other similar women. Delayed detection of breast cancer is a concern for these patients because implants can interfere with mammography. However, using indicators such as stage at diagnosis and tumor size, current research shows that augmentation patients do not experience delayed detection. Furthermore, several comparisons of post-breast cancer survival of augmented versus nonaugmented patients have found no significant differences. In summary, breast implants are not associated with an increased risk of breast cancer incidence or death, and these patients do not experience delayed detection or poorer post-breast cancer survival.
30多年前乳房植入物开始商业化应用后不久,人们就对其潜在致癌性提出了疑问。可追溯到20世纪中叶的动物实验表明,包括硅胶在内的许多材料进行异物植入都可诱发肉瘤。事实上,在此期间美国女性乳腺癌发病率大幅上升。在各国发表的多项正式调查隆乳患者乳腺癌风险的研究中,没有一项显示出风险增加的证据。实际上,大多数研究发现风险低于预期,有些研究的风险降低具有统计学意义。同样,这些患者的乳腺癌死亡率普遍低于其他类似女性的预期。乳腺癌的延迟检测是这些患者的一个担忧,因为植入物会干扰乳房X光检查。然而,根据诊断时的分期和肿瘤大小等指标,目前的研究表明隆乳患者不会出现延迟检测。此外,对隆乳患者与未隆乳患者乳腺癌后生存率的多项比较未发现显著差异。总之,乳房植入物与乳腺癌发病率或死亡风险增加无关,这些患者不会出现延迟检测或乳腺癌后生存率较差的情况。