Going from an A cup to a D cup by the silicone or saline route might mask early stage breast cancer from appearing in a mammogram and affect your survival odds later, according to a new review of medical literature.

That’s troubling news. There were approximately 307,000 breast augmentation surgeries performed in the U.S. alone in 2011, an 800 percent increase since the early 1990s.

Many epidemiological studies indicate that cosmetic breast implants do not directly raise a woman’s risk for breast cancer. But there’s a concern that implants may indirectly harm women by masking early-stage tumors from detection. Cosmetic breast implants can create a shadow on mammograms that obscures part of the breast tissue -- between 22 and 83 percent of parenchymal breast tissue, which constitutes most of the breast.

In a study published in the British Medical Journal on Tuesday, Canadian researchers from Laval University in Quebec, the University of Toronto, the University of Ottawa and other institutions examined 12 large observational studies of breast cancer conducted in the past 20 years to try and gauge the long-term effect of implants on breast cancer detection and survival.

They concluded that the data from those studies showed that women with cosmetic breast implants have a 26 percent increase in risk for being diagnosed at a later stage of breast cancer than women without implants. They then took a look at five additional studies and concluded that cosmetic breast implants came with a 38 percent greater risk of death from breast cancer.

“The research published to date suggests that cosmetic breast augmentation adversely affects the survival of women who are subsequently diagnosed as having breast cancer,” the authors wrote.

The researchers acknowledge that their study has several limitations, many common to meta-analyses of other studies. The studies they examined all had unique features to their methodologies and may have suffered from flaws like misclassification of deaths of subjects that could affect the estimates for breast cancer survival.

“Our results should be interpreted with caution, considering the current gaps and limitations in the available literature,” they wrote. “Further investigations are warranted into the long-term effects of cosmetic breast implants on the detection and prognosis of breast cancer.”

But if the conclusions turn out to be true, what sort of solutions are available? There is some suggestion that MRIs could be a helpful way to diagnose breast cancer in women with implants, but there’s still insufficient evidence to support this, the authors say.

SOURCE: Lavigne et al. “Breast cancer detection and survivial among women with cosmetic breast implants: systematic review and meta-analysis of observational studies.” British Medical Journal published online 1 May 2013.

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