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Breast Cancer after Augmentation: Oncologic and Reconstructive Considerations among Women Undergoing Mastectomy.

Publication ,  Journal Article
Cho, EH; Shammas, RL; Phillips, BT; Greenup, RA; Hwang, ES; Hollenbeck, ST
Published in: Plast Reconstr Surg
June 2017

BACKGROUND: Breast augmentation with subglandular versus subpectoral implants may differentially impact the early detection of breast cancer and treatment recommendations. The authors assessed the impact of prior augmentation on the diagnosis and management of breast cancer in women undergoing mastectomy. METHODS: Breast cancer diagnosis and management were retrospectively analyzed in all women with prior augmentation undergoing therapeutic mastectomy at the authors' institution from 1993 to 2014. Comparison was made to all women with no prior augmentation undergoing mastectomy in 2010. Subanalyses were performed according to prior implant placement. RESULTS: A total of 260 women with (n = 89) and without (n = 171) prior augmentation underwent mastectomy for 95 and 179 breast cancers, respectively. Prior implant placement was subglandular (n = 27) or subpectoral (n = 63) (For five breasts, the placement was unknown). Breast cancer stage at diagnosis (p = 0.19) and detection method (p = 0.48) did not differ for women with and without prior augmentation. Compared to subpectoral augmentation, subglandular augmentation was associated with the diagnosis of invasive breast cancer rather than ductal carcinoma in situ (p = 0.01) and detection by self-palpation rather than screening mammography (p = 0.03). Immediate two-stage implant reconstruction was the preferred reconstructive method in women with augmentation (p < 0.01). CONCLUSIONS: Breast cancer stage at diagnosis was similar for women with and without prior augmentation. Among women with augmentation, however, subglandular implants were associated with more advanced breast tumors commonly detected on palpation rather than mammography. Increased vigilance in breast cancer screening is recommended among women with subglandular augmentation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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Published In

Plast Reconstr Surg

DOI

EISSN

1529-4242

Publication Date

June 2017

Volume

139

Issue

6

Start / End Page

1240e / 1249e

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Surgical Flaps
  • Surgery
  • Statistics, Nonparametric
  • Risk Assessment
  • Retrospective Studies
  • Reference Values
  • Postoperative Complications
 

Citation

APA
Chicago
ICMJE
MLA
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Cho, E. H., Shammas, R. L., Phillips, B. T., Greenup, R. A., Hwang, E. S., & Hollenbeck, S. T. (2017). Breast Cancer after Augmentation: Oncologic and Reconstructive Considerations among Women Undergoing Mastectomy. Plast Reconstr Surg, 139(6), 1240e-1249e. https://doi.org/10.1097/PRS.0000000000003342
Cho, Eugenia H., Ronnie L. Shammas, Brett T. Phillips, Rachel A. Greenup, E Shelley Hwang, and Scott T. Hollenbeck. “Breast Cancer after Augmentation: Oncologic and Reconstructive Considerations among Women Undergoing Mastectomy.Plast Reconstr Surg 139, no. 6 (June 2017): 1240e-1249e. https://doi.org/10.1097/PRS.0000000000003342.
Cho EH, Shammas RL, Phillips BT, Greenup RA, Hwang ES, Hollenbeck ST. Breast Cancer after Augmentation: Oncologic and Reconstructive Considerations among Women Undergoing Mastectomy. Plast Reconstr Surg. 2017 Jun;139(6):1240e-1249e.
Cho, Eugenia H., et al. “Breast Cancer after Augmentation: Oncologic and Reconstructive Considerations among Women Undergoing Mastectomy.Plast Reconstr Surg, vol. 139, no. 6, June 2017, pp. 1240e-1249e. Pubmed, doi:10.1097/PRS.0000000000003342.
Cho EH, Shammas RL, Phillips BT, Greenup RA, Hwang ES, Hollenbeck ST. Breast Cancer after Augmentation: Oncologic and Reconstructive Considerations among Women Undergoing Mastectomy. Plast Reconstr Surg. 2017 Jun;139(6):1240e-1249e.

Published In

Plast Reconstr Surg

DOI

EISSN

1529-4242

Publication Date

June 2017

Volume

139

Issue

6

Start / End Page

1240e / 1249e

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Surgical Flaps
  • Surgery
  • Statistics, Nonparametric
  • Risk Assessment
  • Retrospective Studies
  • Reference Values
  • Postoperative Complications