Cosmetic surgery prior to diagnosis of breast cancer

ABSTRACT

Background Cosmetic breast surgery is amongst the top five most commonly performed cosmetic surgical procedures. With breast cancer being the most common non-skin malignancy in women, the likelihood that a woman undergoing cosmetic breast surgery may have an occult breast cancer needs to be considered. Most of the available data pertaining to breast cancer diagnosis in the setting of cosmetic surgery are from studies of cosmetic breast surgery populations. We report on the prevalence of breast cancer as an incidental finding during cosmetic breast surgery in the context of women subsequently diagnosed with invasive breast cancer.

Methods The Bupa Health Foundation Health and Wellbeing after Breast Cancer Study is a prospective cohort study of 1684 women recruited within 12 months of their first diagnosis with invasive breast cancer. Participants completed an enrolment questionnaire and annual follow-up questionnaires for 5 years.

Results At the second follow-up, 1.5% of women reported having undergone cosmetic breast surgery prior to being diagnosed with breast cancer, 16 had undergone breast reduction and seven had augmentations. Invasive breast cancer was diagnosed at the time of a cosmetic breast procedure in two women, in both an augmentation and a reduction procedure, which is 8.7% (95% confidence interval 23.5% to +20.9%) of the women in our study reporting a cosmetic breast procedure prior to diagnosis.

Conclusions Although prior cosmetic breast surgery was reported by few women, breast cancer was diagnosed in two women during the procedure. Surgeons performing elective breast surgery need to understand and apply consistent, reliable breast cancer screening practices.

Key words::

• BREAST CANCER
• COSMETIC SURGERY
• WOMEN'S HEALTH

ACKNOWLEDGEMENTS

The authors wish to thank Maria La China for study coordination and data management and Jo Bradbury for her contribution to the design and review of the questionnaires. The authors also wish to acknowledge the study participants for their time and efforts. The authors wish to thank the members of our Study Advisory Group: Dr Jacquie Chirgwin, A/Professor John Collins, Professor Graham Giles, Mr Peter Gregory, Mr Stewart Hart, Miss Suzanne Neil and Mrs Avis McPhee.

Conflict of interest The authors report no conflict of interest. The authors alone are responsible for the content and writing of this paper.

Source of funding This study was funded by the Bupa Health Foundation, Novartis Australia, L.E.W. Carty Trust, Connie and Craig Kimberley, The National Health and Medical Research Council of Australia (Grant no. 219279 and 490938), and the Jack and Robert Smorgon Families Foundation and Roy Morgan Research. This research project was supported by the Victorian Government through a Victorian Cancer Agency Research Fellowship. Associate Professor Robin Bell is the recipient of the Victorian Cancer Agency Research Fellowship through the Victorian Cancer Agency.