People with breast implants have been warned to watch out for symptoms after the implants were linked to a rare cancer by US regulators.
The US Food and Drug Administration (FDA) has linked implants to squamous cell carcinoma (SCC), prompting Australia’s Therapeutic Goods Administration to urge people who have had the implants to “regularly monitor their breast implants and consult their implanting surgeon if they have any concerns”.
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Anand Deva, a professor at Macquarie University and a leading surgical scholar who specializes in breast implant health, told 7NEWS.com.au that the cases recorded had mostly occurred in older implants.
But he said “the majority of women walk around with no idea of these risks”, and warned of the dangers that can arise from the procedure without regular check-ups afterwards.
Around 20,000 Australian women receive breast implants every year, Deva told 7NEWS.com.au.
However, reports of SCC related to breast implants are rare.
Fewer than 20 cases of squamous cell carcinoma (SCC) have been reported to the FDA, which the regulator says forms in scar tissue surrounding implants.
“Symptoms of these conditions may include swelling, pain, lumps or skin changes. However, it is important to note that these symptoms may also reflect other breast health issues,” the TGA said.
Deva said the concern with SCCs was that they “were quite aggressive.”
“So usually by the time they are detected they have spread, surgery is not easy and you often need radiotherapy,” Deva told 7NEWS.com.au.
He said there is far from enough implant-related SCC data to determine an underlying cause for these new cases.
Although it’s still too early to say why these cases occur, Deva said it was likely the result of inflammation – which can be a long-term effect of the procedure if left unchecked.
“These cases around breast implants are interesting in that they probably tell us what we already know – that breast implants cause chronic inflammation,” Deva said.
“They are not a benign object. Thus, any foreign body introduced into a patient carries immediate and long-term risks.
SCC itself is common, often believed to be skin cancer and even once detected in the groins of chimney sweeps in London, making it “the first charcoal-related cancer”.
Implants, just like charcoal, can cause inflammation and infection when it becomes a foreign body inside us.
From research on more common implant conditions, such as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), Deva said we know that “squamous cell cancers typically arise after decades of inflammation leading to the immune system, and eventually the cells become malignant”.
In 2019, the TGA removed a number of breast implants from the market in an attempt to reduce the risk of BIA-ALCL.
“The TGA is monitoring the occurrence of the disease in Australia and is in communication with other regulators and international experts in Australia,” the TGA said.
“The TGA strongly encourages you to report all concerns related to medical devices, including breast implants. Your reports help us monitor the performance and safety of medical devices. »
The inevitable deterioration of implants
Deva has long advocated that annual implant screenings be offered as follow-ups by the surgeon, in addition to the monthly checkups that all women are encouraged to perform on themselves.
He says living with breast implants requires ongoing attention and “isn’t as glamorous as some people might think”.
“Obviously when you look at the women even a year after the surgery they are very happy, they look good and everyone thinks they look great.
“Actually, about 10 or 11 years later, the picture is a bit different. They don’t look so good, and certainly if they’ve had one or two kids, things aren’t going so well at the moment. So it’s a bit of a reality check with the more commercial images that we see.
But the TGA stopped short of recommending the removal of the implants.
“At this time, medical experts do not recommend removal of breast implants in patients without symptoms or other abnormalities,” he said.
Ultrasound imaging is recommended for people with breast implants as early as three years after the procedure, Deva said.
Regarding the cases reported to the FDA, Deva says, “These women were exposed to breast implants for a very long time, ranging from 10 years to 50 years, and they probably should have been removed.”
“Follow-ups help the patients but they also help the surgeon,” Deva said, adding that regularly reviewing her work provides insight into how the implants have held up in various patients during childbirth, weight loss and gain, and menopause. .
“So I encourage my colleagues to start doing that, if they aren’t already.”
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