Can breast enlargement cause cancer?

• What breast enlargement is
• Implants and health problems 
• Silicone and cancer
• MHRA advice about Prothese implants
• If you are worried

Breast enlargement (augmentation) is usually done by putting in silicone implants. The implants are a breast shaped bag made of a silicone membrane filled with silicone gel. Implants can also be used as part of recreating a breast shape after surgery for breast cancer. 

There are many different makes of implants. They do not last forever, and sometimes they have to be replaced after 10 to 15 years. Modern designs of silicone implants have a thicker outer shell of silicone rubber, so they are not likely to leak. The gel has been thickened, so it is more difficult for it to leak out.

There have been health concerns about silicone. The concerns are about the silicone gel leaking out of the implant and collecting in the tissues. Some women have said they thought this was the cause of symptoms such as aching and joint pain and extreme tiredness. But several large studies have found that there is no evidence that silicone leakage causes these symptoms. There is information about silicone implants and connective tissue disease in the breast reconstruction section.

Some women worry that the silicone could cause breast cancer. But there is no evidence that silicone increases the risk of breast cancer.

In December 2011 there were reports of problems with a particular type of implant called Prothese (PIP) implants made by a French company. The implants were banned in 2010 after tests found that they contain a type of silicone gel that is not approved for medical use. Tests have not shown any increased risk of health problems from this silicone gel compared to other types of implant. But the implant cover (shell) is more likely to rupture. 

Reports have said there is no increased risk of breast cancer with the implants. But doctors in France have diagnosed one woman with a very rare type of cancer called anaplastic large cell lymphoma. European experts now say there is no increase in risk of this type of lymphoma for women with breast implants in general.

Up to 47,000 women in the UK have had Prothese implants. The Medicines and Regulatory Health Products Agency (MHRA) has reported that approximately 1 in 100 (1%) women in the UK with PIP breast implants had leakage of the gel and had the implants replaced. The MHRA recommends that all patients who have questions about their PIP breast implants should get advice from the surgeon who put in the implants. It is not recommending routine removal because it says there is no evidence that the implants increase the risk of health problems or cancer. There is also no evidence of high rupture rates other than in France.

In France, police have received 2,000 complaints from women who have had the implants. The French Health Minister has encouraged French women to have the implants removed as a preventive measure, but said that it was not urgent and women don't need to have the implants removed straight away. The MHRA is waiting for further tests to see if they show any evidence to support the decision made in France. They will give further advice if necessary.

The Department of Health set up an expert group led by the NHS Medical Director to look at all the available evidence. They say that what the MHRA said still stands and that there is not enough evidence to say that the implants should be removed. They also agree that there is no link with cancer.

The expert group is looking at how information about this type of surgery is collected and how this type of surgery is regulated. The Care Quality Commission are also going to review how the clinics are registered and look at how they inspect them.

If you have a PIP implant or are not sure which type you have had you should speak to your surgeon or GP.  It depends on whether you had your implant put in within the NHS or the private sector as to how the NHS will care for you.

If you had your implant put in within the NHS they say that

• They will contact you and tell you that your implant was a PIP implant. They will give you advice and information.
• You can contact for GP or surgeon yourself if you are worried before they contact you
• You can have tests to check if your implant has ruptured
• You will have the implant removed if your surgeon thinks you need to or if you are still worried following your consultation with them – you can have the implant replaced if you want to

If you had your implant put in privately the Department of Health say they are working with the private sector companies to try to make sure you get the same care as people treated within the NHS. You can be seen within the NHS

• If you are entitled to NHS care
• The private clinic no longer exists or refuses to care for you

You can have the implant removed within the NHS if having seen a surgeon they think you need it removed or you are still worried. The NHS will not replace the implant in this situation.