A study by the Karl Landsteiner University of Health Sciences (KL Krems) highlights crucial findings regarding the infrequent check-ups among women with breast implants.
An analysis of over 1,000 cases revealed that more than 80 % of women skipped recommended annual screenings. Silent ruptures of silicone implants often go undetected for years, potentially leading to serious long-term complications, including inflammatory foreign body reactions (siliconomas) and certain breast implant associated cancers.
Published in the Journal of Clinical Medicine, the study points out that despite the recommendation of regular check-ups by physicians, many women only come for follow-up care when pain or deformation of the breast has already occurred. The results of the study emphasize the importance of early detection and education to promote regular follow-up examinations.[1]
Lack of follow-up care for breast implants leads to delayed detection of ruptures. A new study highlights the risk of serious long-term consequences and calls for greater awareness.
Complications
Breast implants are typically robust medical devices, widely used in aesthetic and reconstructive surgeries. However, complications can occur, ranging from pain to visible breast deformation, or undetected implant damage.
Over time, these issues can pose significant health risks. Regular check-ups could help mitigate these risks, but until now, little data existed on how often such follow-ups are conducted.
A new study from a research team from the Division of Plastic, Aesthetic and Reconstructive Surgery at University Hospital St. Pölten, an education and research site of KL Krems, sheds light on this issue in Austria.
Alarming Outcomes
“The findings of our study are deeply concerning,” noted Tonatiuh Flores, lead author and physician at the Clinical Division of Plastic, Aesthetic and Reconstructive Surgery at KL Krems.
“Although we encourage our patients to attend annual routine examinations based on international guidelines, our study shows that only a small number of women actually do so. Regular screenings could detect implant issues early and prevent severe complications,” Flores added,
Study
The study analyzed 1,128 breast surgeries performed between August 2018 and December 2023. Shockingly, only 15 % of implant carriers underwent regular follow-ups. In nearly 75% of cases, ruptures were only identified when women sought medical consultation for pain or noticeable changes in breast shape—often on average 17 years post-implantation.
“We believe that many implant ruptures go undetected for years,” explained Flores.
“This delay can lead to severe consequences, such as siliconomas — foreign body reactions to silicone — and the rare but serious breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a new and recently recognized non-Hodgkin lymphoma (NHL).”
While breast augmentation is generally considered safe, in rare cases, breast implant-associated cancers can develop.
Despite the relatively low incidence of BIA-ALCL, the increasing use of breast implants for cosmetic or post-mastectomy reconstruction purposes places BIA-ALC this form of NHL as an emerging medical challenge. [2]
In addition, Breast Implant-Associated Squamous Cell Carcinoma (BIA-SCC) is another emerging neoplastic complications related to breast implants. Although a rare complication of breast implantation BIA-SCC can result in significant morbidity and mortality. [3][4]
Breast augmentation after BIA-ALCL?
Despite improvements in the overall understanding of BIA-ALCL, communicating a prognosis to patients remains challenging. This is, in part, due to limited long-term follow-up data. This lack of follow-up data may negatively impact the decision-making, including recommendations for subsequent reconstructive procedures. [5]
However, the current Standard of Care treatment of BIA-ALCL involves surgical resection with implant removal and complete capsulectomy. And while breast reconstruction following BIA-ALCL management can be performed with acceptable complications if complete surgical ablation is possible, patients with extensive disease at presentation should be considered for 6- to 12-month delayed reconstruction followed by an interval positive emission tomography/computed tomography evaluation. [6]
Neglected follow-up care
The study underscores the urgent need for increased awareness about the risks of neglecting follow-up care.
Most women in the study only sought help when aesthetic or painful symptoms arose – often too late to avoid significant complications.
Is action needed?
The researchers concluded that because the incidence of breast cancer and, therefore, the need for breast reconstruction is expected to increase, proactive patient information by surgeons and healthcare providers is crucial.
“Our aim is to improve patient awareness about the long-term risks associated with implants,” explained Prim. Prof. Schrögendorfer, Head of the Division of Plastic, Aesthetic and Reconstructive Surgery at the University Hospital St. Pölten.
The researchers also advocate for the introduction of monitoring systems, such as implant registries, to enhance aftercare efficiency.
Reference
[1] Flores T, Kerschbaumer C, Glisic C, Weber M, Schrögendorfer KF, Bergmeister KD. Breast Implants: Low Rate of Annual Check-Ups Results in Delayed Presentation of Ruptured Implants. J Clin Med. 2024 Oct 31;13(21):6545. doi: 10.3390/jcm13216545. PMID: 39518683; PMCID: PMC11547161.
[2] Marra A, Viale G, Pileri SA, Pravettoni G, Viale G, De Lorenzi F, Nolè F, Veronesi P, Curigliano G. Breast implant-associated anaplastic large cell lymphoma: A comprehensive review. Cancer Treat Rev. 2020 Mar;84:101963. doi: 10.1016/j.ctrv.2020.101963. Epub 2020 Jan 13. PMID: 31958739.
[3] Glasberg SB, Sommers CA, McClure GT. Breast Implant-associated Squamous Cell Carcinoma: Initial Review and Early Recommendations. Plast Reconstr Surg Glob Open. 2023 Jun 14;11(6):e5072. doi: 10.1097/GOX.0000000000005072. PMID: 37325375; PMCID: PMC10266515.
[4] Niraula S, Katel A, Barua A, Weiss A, Strawderman MS, Zhang H, Manrique O, O’Connell A, Pandey SR, Dhakal A. A Systematic Review of Breast Implant-Associated Squamous Cell Carcinoma. Cancers (Basel). 2023 Sep 12;15(18):4516. doi: 10.3390/cancers15184516. PMID: 37760485; PMCID: PMC10526244.
[5] O’Connell RL, Sharma B, El-Sharkawi D, Wotherspoon A, Attygalle AD, MacNeill F, Khan AA, Tasoulis MK. Oncological Outcomes After Multidisciplinary Management of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Ann Surg Oncol. 2023 Oct;30(10):6170-6175. doi: 10.1245/s10434-023-13889-3. Epub 2023 Jul 15. PMID: 37454017.
[6] Lamaris GA, Butler CE, Deva AK, Miranda RN, Hunt KK, Connell T, Lipa JE, Clemens MW. Breast Reconstruction Following Breast Implant-Associated Anaplastic Large Cell Lymphoma. Plast Reconstr Surg. 2019 Mar;143(3S A Review of Breast Implant-Associated Anaplastic Large Cell Lymphoma):51S-58S. doi: 10.1097/PRS.0000000000005569. PMID: 30817556.
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