Re: Woman with fake boobs has real health worries

[Guest guest]

And this is why women with aging implants continue having mammograms, which

rupture

their implants.

I think it is disgraceful.

>

> http://www.msnbc.msn.com/id/12991972/

>

> Woman with fake boobs has real health worries

> A 40-year-old wants to know if breast implants ruin

> mammogram results. `Today' health editor Dr. Judith

> Reichman says they could affect treatment

>

> Dr. Judith Reichman

> 'Today' show contributor

>

> Dear Dr. Reichman: I'm 40 and I know that I need to

> begin to have annual mammograms. I had breast implants

> six years ago, and now I'm worried. Can the mammogram

> procedure rupture the implants? And can my implants

> obscure signs of breast cancer? — Busty and bothered

>

> Dear Busty: You have two valid concerns. Breast

> augmentation is the second most frequent surgery

> performed by plastic surgeons. It's estimated that

> over 4 million women have had this surgery,

> approximately 80 percent for cosmetic reasons and 20

> percent for reconstruction after mastectomy. Breast

> cancer will affect 12.5 percent or 1 out of 8 women in

> their lifetime. As breast cancer incidence peaks

> (between the ages of 50 and 69) women who have had

> augmentation will be faced by the same concern —can

> breast cancer be found if you have an implant?

>

> Recent studies of over 36,000 women with implants

> compared the observed rate of diagnosed breast cancer

> in these women with that expected in the general

> population. Paradoxically, it was found that the

> breast cancer incidence in women with augmentation not

> only did not increase, but was somewhat lower than

> that seen in the general population. The reason this

> is somewhat surprising is that implants can cause a 15

> to 50 percent decrease in the mammographically

> visualized breast tissue and several studies have

> reported false negative mammograms (those that missed

> the cancer) in 12 to 67 percent of women with

> augmentation.

>

> The latter numbers are hardly reassuring, but it's

> possible (though many feel not medically probable)

> that breast implants may decrease breast cancer

> incidence by:

>

> Compressing breast tissue and interfering with its

> blood supply

>

> Decreasing temperature in the breast

>

> Stimulating an immunological response which helps

> destroy potential breast cancer cells.

>

> It may just be, however, that the apparent decreased

> incidence of breast cancer in women with breast

> implants reflects the fact that these women are more

> likely to be thin. (Obesity is a significant risk

> factor for breast cancer.) Also, the women with breast

> implants tend to be in a higher socioeconomic group

> with better nutrition, exercise, cancer screening, and

> access to medical care.

>

> Having given you this reassurance let me point out

> that in order to properly visualize an augmented

> breast, the breast should be compressed in a special

> fashion that may require 4 separate views. And if

> biopsy is required, you'll need to have an open biopsy

> so that the implant is not punctured. Otherwise, you

> could have an ultrasound-guided needle biopsy or a

> stereotactic biopsy.

>

> If cancer is found, the implants, especially if placed

> above the chest muscles, make it difficult to treat

> with " just " a lumpectomy and radiation. It can be

> difficult to achieve a cancer free surgical margin

> while preserving the implant. Radiation may also cause

> the implant to harden and contract.

>

> HEALTH with Dr. Judith Reichman

> • Woman with fake boobs has real health worries

> • Been told you have an ovarian cyst? Don't panic

> • Fish or foul: How healthy is seafood?

> • How good is your Pap test knowledge?

> • I have herpes: Is my sex life ruined?

>

> Let me address your concern that a mammogram could

> " hurt " your implants. There were only 41 cases of

> implant ruptures during mammography reported to the

> U.S. Food and Drug Administration between June 1992

> and October 2002. Another 17 cases related to

> mammograms have been reported in the medical

> literature. This occurrence is obviously quite rare,

> so implants should not be a disincentive to getting

> your mammogram.

>

>

>

> Finally, some of my patients ask if ultrasound, which

> is a softer, gentler procedure, can be used to screen

> for cancer in lieu of a mammogram. My answer is no.

> Ultrasound doesn't pick up the minute calcifications

> that are the hallmark of early breast cancer and its

> results vary tremendously based on who is performing

> and viewing the image. Ultrasound as an adjunct test

> used to distinguish between solid and cystic masses or

> to help assess very dense breasts, but it should not

> be the primary screening tool to detect breast cancer.

>

> An MRI can be used to detect a silent rupture in a

> silicone implant, but routine use for breast cancer

> detection is limited to high risk women (those who

> have a strong genetic history, are known to have BRCA

> mutations or who had had previous diagnosed breast

> cancer). This may become " the test of the future " but

> currently it's very expensive and has a high rate of

> false positive results (findings that require a biopsy

> but turn out to be benign).

>

> Dr. Reichman's Bottom Line: You've already manifested

> breast concerns by having an augmentation procedure.

> Your implants do not increase your risk of breast

> cancer. Don't raise your risk of a delayed diagnosis

> by letting your implants prevent you from getting a

> mammogram.

>

> Dr. Judith Reichman, the " Today " show's medical

> contributor on women's health, has practiced

> obstetrics and gynecology for more than 20 years. You

> will find many answers to your questions in her latest

> book, " Slow Your Clock Down: The Complete Guide to a

> Healthy, Younger You, " which is now available in

> paperback. It is published by Morrow, a

> division of Harper.

>