Women prefer silicone implants after double mastectomy

A new study has found that women who receive silicone implants after a double mastectomy are more satisfied with their breasts than women who receive saline implants. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings may help physicians and breast cancer survivors as they together make decisions related to postmastectomy reconstructive surgery.

Women who have one or both of their breasts removed as a treatment for breast cancer may wish to undergo breast reconstructive surgery with implants. Such postmastectomy implants may be filled with either saline (salt water) or silicone gel, and while both types have been approved by the US Food and Drug Administration, the safety and effectiveness of breast implants remain under close scrutiny. In addition to safety and efficacy, patient satisfaction and quality of life are also important considerations when comparing implant types. To this end, Colleen McCarthy, MD, of Memorial Sloan-Kettering Cancer Center in New York City led a team that surveyed 672 women who had undergone postmastectomy reconstructive surgery with implants at one of three centers in North America.

A total of 472 patients in the study completed questionnaires. In 176 women, silicone implants were placed; in 306, saline implants were used. The investigators found that patients with silicone implants were more satisfied with their reconstructed breasts than patients with saline implants. Receiving radiation therapy after a mastectomy had a significantly negative effect on breast satisfaction in both silicone and saline implant recipients. In addition, for women who received either silicone or saline implants, satisfaction diminished over time.

"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," said Dr. McCarthy. "It also appears that patient satisfaction with postmastectomy implant-based reconstruction is generally high and that individual treatment variables-such as implant type-explain only a relatively small amount of the variance. 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.