This month the British Medical Journal (BMJ) published an article entitled “Breast Cancer Detection and Survival Among Women With Cosmetic Breast Implants.” It’s a pretty benign title and one I could have easily skimmed over were it not for the email that hit my inbox:
Cosmetic Implants Adversely Affect Breast Cancer Survival
This frightening declaration was the subject line of an email from Medscape, a news service that summarizes the latest scientific journal publications and delivers them to your email. It obviously caught my attention- breast implants are a big part of the plastic surgery business. According to the American Society of Plastic Surgery 2010 statistics, nearly 300,000 women a year undergo augmentation mammaplasty.
So this shocking headline should be all over major news networks, right? I’ve googled But this is an excellent demonstration of why it’s important to read the article itself. And if you don’t have access to the article, let me summarize a few key points for you.
- The BMJ study is a meta-analysis, which a way to lump several previous studies together and analyze them as a group. The very best type of study would be to randomize women to different two different groups- one that receives breast implants, and one that does not- then follow them for several years and see which group has a higher risk of dying from breast cancer. This clearly isn’t possible, so the next best thing is to look back (retrospectively) at women who had breast augmentation compared to women who didn’t and compare those two groups. The BMJ meta-analysis looked at several studies that essentially did just that.
- 12 studies were included in the initial analysis, which did not conclude that breast implants increase the risk of dying from breast cancer. Then the authors did some complicated statistical analyses, which I will fully admit are beyond my rudimentary grasp of statistics. But the end result was that they excluded 7 of the studies and analyzed only the remaining 5, which is a very small number.
- Looking at those 5 studies, only one of the five actually concluded that breast implants increase the risk of dying from cancer. The other four studies were not statistically significant (i.e. not able to conclude that breast augmentation decreases breast cancer survival.)
- The total number of patients looked at in the meta-analysis was not given, so we have no idea if there were enough patients to accurately represent the overall population.
- The authors of the study themselves are very cautious in drawing their conclusions, stating only that “This systematic review suggests that women with cosmetic breast implants have later stage tumors at diagnosis of breast cancer.” (emphasis is mine).
Now I must warn you that I am not a statistician. And if someone who is has any input into the way the stats were done in this study, I would love to hear their opinion. But it is clear that the conclusions of this study were much more tentative than the way it is being advertised by Medscape, and on some of the websites I’ve seen discussing the article (click here and here to see how others interpreted this article). The best conclusion to draw from this is that more research needs to be done in this area. And keep in mind that there are several studies which suggest no difference in breast cancer survivability for patients who have had breast augmentation. For now the jury is still out, and I would not recommend basing your decision to have breast augmentation on reading a single scientific study.