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Melvin J. Silverstein, MD; Neal Handel, MD; Parvis Gamagami, MD; James R. Waisman, MD; Eugene D. Gierson, MD; Robert J. Rosser, MD; Robert Steyskal, MD; William Colburn, MD

Arch Surg. 1988;123(6):681-685.

Abstract
• More than 1 million American women have undergone augmentation mammoplasty; 100000 (10%) will develop or already have developed breast cancer. Between March 1981 and August 1986, 20 patients with previous augmentation mammoplasty were treated for breast carcinoma. All patients had unilateral infiltrating carcinomas and presented with a palpable mass. None of the cancers were occult (discovered mammographically). Thirteen patients (65%) had metastases to axillary lymph nodes. During the same period, 733 nonaugmented patients with breast cancer were treated: 207 (28%) had involved axillary nodes, 194 (26%) had in situ lesions, and 154 cancers (21%) were occult. Augmentation mammoplasty with silicone-gel—filled implants reduces the ability of mammography, our best diagnostic tool, to visualize breast parenchyma. When compared with our own nonaugmented breast cancer population, augmented patients with breast cancer presented with more advanced disease; they had a higher percentage of Invasive lesions and positive axillary nodes, resulting in a worsened prognosis.

(Arch Surg 1988;123:681-685)

Author Affiliations
From The Breast Center and Valley Hospital Medical Center, Van Nuys, Calif (Drs Silverstein, Handel, Gamagami, Waisman, Gierson, Rosser, Steyskal, and Colburn); the Department of Medicine, UCLA School of Medicine, Los Angeles (Dr Waisman); and the Department of Pathology, University of Southern California School of Medicine, Los Angeles (Dr Rosser).

Footnotes
Accepted for publication Sept 1, 1987.

Read in part before the American Society of Clinical Oncology, Atlanta, May 19, 1987.

Reprint requests to The Breast Center, 14624 Sherman Way, Van Nuys, CA 91405 (Dr Silverstein).

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