Breast implants linked to greater risk of dying from breast cancer? Not so fast.

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A new meta-analysis suggests that breast cancer may be more deadly for women who have cosmetic implants, largely thought to be a result of receiving the diagnosis at a later stage. Study authors explain that the breast implants are radio-opaque meaning they appear light on the dark breast tissue background which makes it harder to detect breast cancer at an early stage using mammography. In fact, the technique used to image women with implants leaves one-third of the breast inadequately imaged, potentially leading to an increase in false negative mammograms. This may be an especially relevant finding, given that breast augmentation was the number one cosmetic surgery in the country in 2011.

The meta-analysis assessed 12 cross-sectional studies and about 29,000 women and compared stage-distribution of breast cancer between those women with and without implants. Researchers found that women with implants were 38 percent more likely to die from the disease. They also found that these women were 26 more likely to have non-localized breast cancer, although this finding was not significant.

However, the study authors warn that these results should be interpreted cautiously and say that further study is needed due to the fact that some of the studies used in the meta-analysis failed to take into account confounders and most studies had relatively short follow-up times. And, although they say that few of the studies used actually showed an association between implants and breast cancer, they believe that a link is plausible.

ACSH s Dr. Gilbert Ross says, This is a most confusing study. Meta-analysis trying to aggregate numerous studies to distill better significance data is already fraught with opportunities for error, and these authors have yielded to that temptation. Even they seem unclear about what they believe the data show, or even hint at. They conducted this meta-analysis using studies that did not even bother to control for confounders this is the worst way to do a meta-analysis.

But ACSH can agree with study authors when they say that The fact that implants may interfere with early detection of breast cancer is particularly relevant and carries with it important clinical and public health implications.