New research from the US found that women who have silicone implants following a mastectomy as a result of breast cancer are more satisfied with their breasts than women who have saline implants; the researchers hope their findings will help doctors and their breast cancer patients discuss options for reconstructive surgery following breast removal.
You can read about the study, led by Dr Colleen McCarthy, a reconstructive surgeon at the Memorial Sloan-Kettering Cancer Center in New York, online in the 8 November issue of the journal Cancer.
In the US, there are two types of breast implants available for women who want to have them fitted after having their breasts removed as a result of cancer treatment: saline (the implant is filled with salt water), and silicone (the implant is filled with silicone gel).
While both types are approved by the US Food and Drug Administration (FDA), they remain under close surveillance, and in considering options, doctors and patients need the best information available, not only about safety and efficacy, but also in terms of patient satisfaction and impact on quality of life, which is why McCarthy and colleagues carried out their study.
McCarthy told the press that:
“We now know that women who elect to proceed with the placement of a silicone implant report higher satisfaction with their reconstructed breasts than those who choose saline implants.”
She said they also found that “satisfaction with post-mastectomy implant-based reconstruction is generally high”, and that other factors like type of implant explain only a small amount of the variance they found.
“Patient counseling should reflect these realities in order to reassure patients that high satisfaction may be obtained with both saline and silicone implants,” she added.
For the study, McCarthy and colleagues sent BREAST-Q (Reconstruction Module) questionnaires to 672 women who had received post-mastectomy reconstructive surgery with implants at one of three centers in North America.
The results showed that:
- 482 of the women completed questionnaires.
- The 176 patients with silicone implants were significantly more satisfied with their reconstructed breasts than the 306 who had received saline ones.
- Patients who also had radiation therapy after a mastectomy were significantly less satisfied with their breasts, in both silicone and saline groups.
- Satisfaction in both groups diminished over time.
The researchers concluded that:
“In the setting of postmastectomy reconstruction, patients who received silicone breast implants reported significantly higher satisfaction with the results of reconstruction than those who received saline implants.”
They recommended that these findings be used to “optimize shared medical decision-making by providing patients with realistic postoperative expectations”.
“Patient satisfaction with postmastectomy breast reconstruction.”
Colleen M. McCarthy, Anne F. Klassen, Stefan J. Cano, Amie Scott, Nancy VanLaeken, Peter A. Lennox, Amy K. Alderman, Babak J. Mehrara, Joseph J. Disa, Peter G. Cordeiro and Andrea L. Pusic
DOI: 10.1002/cncr.25552
Additional source: Wiley-Blackwell.
Written by: Catharine Paddock, PhD