Unité de Recherche en Santé des Populations, URESP, Centre de recherche FRSQ du Centre hospitalier affilié universitaire de Québec and Laval University, Quebec City, Quebec, Canada.
Cancer Epidemiol Biomarkers Prev. 2012 Oct;21(10):1868-76. doi: 10.1158/1055-9965.EPI-12-0484. Epub 2012 Jul 31.
Cosmetic breast implants may impair the ability to detect breast cancers. The aims of this study were to examine whether implants and implant characteristics are associated with more advanced breast tumors at diagnosis and poorer survival.
Study population includes all invasive breast cancer cases diagnosed during follow-up of the large Canadian Breast Implant Cohort. A total of 409 women with cosmetic breast implants and 444 women with other cosmetic surgery were diagnosed with breast cancer. These women were compared for stage at diagnosis using multinomial logistic regression models. Cox proportional hazards regression models were used for breast cancer-specific mortality analyses. Comparisons were also conducted according to implant characteristics.
Compared with women with other cosmetic surgery, those with cosmetic breast implants had at later stage breast cancer diagnosis (OR of having stage III/IV vs. stage I at diagnosis: 3.04, 95% confidence interval (CI): 1.81-5.10; P < 0.001). A nonstatistically significant increase in breast cancer-specific mortality rate for women with breast implants relative to surgical controls was observed (HR = 1.32, 95% CI: 0.94-1.83, P = 0.11). No statistically significant differences in stage and breast cancer mortality were observed according to implant characteristics.
At diagnosis, breast cancers tended to be at more advanced stages among women with cosmetic breast implants. Breast cancer-specific survival was lower in these women although the reduction did not reach statistical significance.
Further investigations of the effect of breast implants on breast cancer prognosis are warranted.
美容用乳房植入物可能会影响乳腺癌的检测能力。本研究旨在探讨植入物及其特征是否与诊断时更晚期的乳腺癌肿瘤以及更差的生存相关。
研究人群包括在大型加拿大乳房植入物队列的随访中诊断出的所有浸润性乳腺癌病例。共有 409 名接受美容乳房植入物的女性和 444 名接受其他美容手术的女性被诊断患有乳腺癌。使用多项逻辑回归模型对这些女性的诊断时分期进行比较。使用 Cox 比例风险回归模型进行乳腺癌特异性死亡率分析。还根据植入物特征进行了比较。
与接受其他美容手术的女性相比，接受美容乳房植入物的女性诊断时的乳腺癌分期更晚（诊断时 III/IV 期与 I 期的比值比为 3.04，95%置信区间：1.81-5.10；P<0.001）。观察到乳房植入物的女性乳腺癌特异性死亡率相对手术对照组略有升高（HR=1.32，95%置信区间：0.94-1.83，P=0.11）。根据植入物特征，分期和乳腺癌死亡率无统计学差异。
在诊断时，美容乳房植入物女性的乳腺癌倾向于更晚期。尽管这些女性的乳腺癌特异性生存率降低，但未达到统计学意义。
需要进一步研究乳房植入物对乳腺癌预后的影响。
