Cancer in the augmented breast. Diagnosis and prognosis

The stage of breast cancer at diagnosis in women who have undergone augmentation mammoplasty has been examined with conflicting results. Additional evaluation of this population is needed.

A retrospective review of a large cancer center's breast cancer registry for a 116-month period was performed. Comparisons of patient age, method of detection, and pathologic stage of disease at presentation were performed for 33 patients with augmented breasts and 1735 patients with nonaugmented breasts who were treated.

Twenty-four percent of the patients with augmented breasts and 42% of those with nonaugmented breasts had mammographically detected cancers (P = NS). The incidence of ductal carcinoma in situ in the two groups was similar (18% versus 15%). Sizes of the mammographically detected tumors in the two groups were comparable; however, palpable tumors in the augmented group were significantly smaller than were those in the nonaugmented group. Overall, a significant difference in axillary lymph node involvement was detected, with 19% of the augmented group and 41% of the nonaugmented group having positive lymph nodes. In patients with palpable tumors, axillary lymph node involvement also was significantly different, with 22% of the patients with augmented breasts and 58% of those with nonaugmented breasts having axillary lymph node metastases. In the mammographically detected tumors, there was no significant difference in axillary lymph node metastases between the patients with augmented (13%) and those with nonaugmented (15%) breasts.

Early detection of breast cancer is possible in the patient who has undergone augumentation mammoplasty. Mammography was successful in detecting occult lesions, and palpation detected smaller tumors. In this cohort, there was no evidence to suggest that the patients with augmented breasts had more advanced disease at presentation.