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A novel approach to breast-conserving surgery in patients with silicone breast implants and newly diagnosed breast cancer

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Breast augmentation with implants is a popular cosmetic procedure which has been performed for nearly six decades. As the number of breast augmentation procedures continually rises, we increasingly encounter breast cancer patients who have silicone implants. A significant portion of these patients includes candidates suited for lumpectomy. In these cases, a major concern is the potential exposure of the implant during lumpectomy while an additional consideration is the need to replace the implants due to their age or condition. The purpose of this study is to present an original surgical approach to patients with breast implants requiring breast conservative resection due to breast carcinoma.

Methods

Over the course of 10 years, breast-augmented candidates for a lumpectomy who underwent a technique that combines lumpectomy with the replacement of the old implant through an incision from the previous scar in the inframammary fold (IMF) were reviewed. With this approach, after removal of the implant through the IMF incision, the tumor is resected with appropriate surgical margins from inside the implant pocket, leaving the overlying skin intact. Data on demographic characteristics, implants, oncologic information, intraoperative surgical findings, and complication were collected. The implant information included brand, size, age, plan of dissection, and condition of the implant as assessed preoperatively. Oncologic information included tumor type, number of tumors, size, and location. Surgical information included the size of the tissue excised, condition of the implant removed, as well as characteristics of the new implants, plane of augmentation, and intraoperative and postoperative complications. All breast specimens were marked and weighed, and the patients were followed-up postoperatively for at least 6 months by the plastic and breast surgeons and by the oncologists.

Results

This technique has been employed in 21 patients with previous breast augmentation and a recent diagnosis of breast carcinoma. The average implant age was 13.3 years. The average tumor size was 2.1 cm × 2.8 cm. All patients had clear surgical margins. No significant complications were reported.

Conclusions

This technique enables the performing of a lumpectomy procedure without adding additional scars to the breast, the exchange of the implant in a simultaneous procedure, and the decrease of the risk of implant exposure due to additional scars on the breast parenchyma. It minimizes postoperative complications and provides excellent results both therapeutically and aesthetically.

Level of evidence: Level III, therapeutic study

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Author information

Authors and Affiliations

  1. Department of Plastic Surgery, Shamir Medical Center, 70300, Zerifin, Israel

    Sofiya S. Gorsky, Adaya Rosenthal-Green & Lior Heller

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Sofiya S. Gorsky, Adaya Rosenthal-Green, Tali Arazi-Kleinman, Moshe Papa & Lior Heller

  3. Department of Breast Radiology, Shamir Medical Center, Zerifin, Israel

    Tali Arazi-Kleinman

Authors
  1. Sofiya S. Gorsky
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  2. Adaya Rosenthal-Green
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  3. Tali Arazi-Kleinman
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  4. Moshe Papa
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  5. Lior Heller
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Corresponding author

Correspondence to Lior Heller.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This is a retrospective study which was approved by the Shamir Medical Center Research Ethics Committee.

Consent for publication

No patient identification information was included in the current study; however, the patients whose data and pictures are included in the paper signed informed consent regarding publishing the data and the photographs.

Competing interests

Sofiya S. Gorsky, Adaya Rosenthal-Green, Tali Arazi-Kleinman, Moshe Papa, and Lior Heller declare no conflict of interest.

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Gorsky, S.S., Rosenthal-Green, A., Arazi-Kleinman, T. et al. A novel approach to breast-conserving surgery in patients with silicone breast implants and newly diagnosed breast cancer. Eur J Plast Surg 45, 285–291 (2022). https://doi.org/10.1007/s00238-021-01886-2

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  • DOI: https://doi.org/10.1007/s00238-021-01886-2

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