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01-07-2009 | Original Article

Breast Cancer Following Augmentation Mammaplasty with Polyacrylamide Hydrogel (PAAG) Injection

Authors: Ning-Xin Cheng, Li-Gang Liu, Li Hui, Yuan-Liang Chen, Shi-Liang Xu

Published in: Aesthetic Plastic Surgery | Issue 4/2009

Abstract

Polyacrylamide hydrogel (PAAG) as an implanted material for augmentation mammaplasty has been used for years in China. Many kinds of complications associated with PAAG use have been reported in the clinical literature. This report presents two cases of breast cancer occurring after injection of PAAG in augmented breasts. The delayed diagnosis and more aggressive disease due to PAAG injection should be cause for concern. It is very important to detect breast cancer early when it is covered by the induration of the injected gel and inflammation reaction after PAAG injection. PAAG injection for augmentation mammaplasty may affect the outcome of breast cancer diagnosis and prognosis.

Deapen DM, Pike MC, Casagrande JT, Brody GS (1986) The relationship between breast cancer and augmentation mammaplasty: an epidemiologic study. Plast Reconstr Surg 77(3):361–367PubMedCrossRef

Clark CP III, Peters GN, O’Brien KM (1993) Cancer in the augmented breast: diagnosis and prognosis. Cancer 72(7):2170–2174PubMedCrossRef

Mellemkjaer L, Kjoller K, Friis S, McLaughlin JK, Høgsted C, Winther JF, Breiting V, Krag C, Krüger Kjaer S, Blot WJ, Olsen JH (2000) Cancer occurrence after cosmetic breast implantation in Denmark. Int J Cancer 88(2):301–306PubMedCrossRef

Ohtake N, Koganei Y, Itoh M, Shioya N (1989) Postoperative sequelae of augmentation mammaplasty by injection method in Japan. Aesth Plast Surg 13(2):67–74CrossRef

Fernandez-Cossio S, Castano-Oreja MT (2006) Biocompatibility of two novel dermal fillers: histological evaluation of implants of a hyaluronic acid filler and a polyacrylamide filler. Plast Reconstr Surg 117(6):1789–1796PubMedCrossRef

Bello G, Jackson IT, Keskin M, Kelly C, Dajani K, Studinger R, Kim EM, Lincoln D, Silberberg B, Lee A (2007) The use of polyacrylamide gel in soft-tissue augmentation: an experimental assessment. Plast Reconstr Surg 119(4):1326–1336PubMedCrossRef

Cheng NX, Xu SL, Deng H, Ding XB, Zhang XM, Wu DH, Zhong H, Sun ZH (2006) Migration of implants: a problem of injectable PAAG in aesthetic plastic surgery. Aesth Plast Surg 30:215–225CrossRef

Cheng NX, Wang RL, Wang JH, Zhang XM, Zhong H (2002) Complications of breast augmentation with injected hydrophilic polyacrylamide gel. Aesth Plast Surg 26(5):375–382CrossRef

Qiao Q, Wang X, Sun J, Zhao R, Liu Z, Wang Y, Sun B, Yan Y, Qi K (2005) Management for postoperative complications of breast augmentation by injected polyacrylamide hydrogel. Aesth Plast Surg 29(3):156–161CrossRef

10.

Evstatiev D (2006) Late complications after application of polyacrylamide hydrogel. Eur J Plast Surg 29(3):127–132CrossRef

11.

Deapen DM, Hirsch EM, Brody GS (2007) Cancer risk among Los Angeles women with cosmetic breast implants. Plast Reconstr Surg 119(7):1987–1992PubMedCrossRef

12.

Cahan AC, Ashikari R, Pressman P, Cody H, Hoffman S, Sherman JE (1995) Breast cancer after breast augmentation with silicone implants. Ann Surg Oncol 2(2):121–125PubMedCrossRef

13.

Hölmich LR, Mellemkjær L, Gunnarsdóttir KA, Tange UB, Krag C, Møller S, McLaughlin JK, Olsen JH (2003) Stage of breast cancer at diagnosis among women with cosmetic breast implants. Br J Cancer 88:832–838PubMedCrossRef

14.

Silverman BG, Brown SL, Bright RA, Kaczmarek RG, Arrowsmith-Lowe JB, Kessler DA (1996) Reported complications of silicone gel breast implants: an epidemiologic review. Ann Intern Med 124(8):744–756PubMed

15.

Brinton LA, Lubin JH, Burich MC, Colton T, Brown SL, Hoover RN (2000) Breast cancer following augmentation mammoplasty (United States). Cancer Causes Control 11(9):819–827PubMedCrossRef

16.

Pukkala E, Boice JD Jr, Hovi SL, Hemminki E, Asko-Seljavaara S, Keskimäki I, McLaughlin JK, Pakkanen M, Teppo L (2002) Incidence of breast and other cancers among Finnish women with cosmetic breast implants, 1970–1999. J Long Term Eff Med Implants 12(4):271–279PubMed

17.

Brisson J, Holowaty EJ, Villeneuve PJ, Xie L, Ugnat AM, Latulippe L, Mao Y (2006) Cancer incidence in a cohort of Ontario and Quebec women having bilateral breast augmentation. Int J Cancer 118(11):2854–2862PubMedCrossRef

18.

Okubo M, Hyakusoku H, Kanno K, Fumiiri M (1992) Complications after injection mammaplasty. Aesth Plast Surg 16(2):181–187CrossRef

19.

Chen GQ, Liu R, Gu YY (2004) Pathological analysis of breast carcinoma after silicone gel injection. Zhonghua Zheng Xing Wai Ke Za Zhi 20(5):330–332 (in Chinese)PubMed

20.

Tanaka Y, Morishima I, Kikuchi K (2008) Invasive micropapillary carcinomas arising 42 years after augmentation mammoplasty: a case report and literature review. World J Surg Oncol 6:33PubMedCrossRef

21.

Xi TF, Fan CX, Feng XM, Wan ZY, Wang CR, Chou LL (2006) Cytotoxicity and altered c-myc gene expression by medical polyacrylamide hydrogel. J Biomed Mater Res A 78(2):283–290PubMed

22.

Christensen LH, Breiting VB, Aasted A, Jørgensen A, Kebuladze I (2003) Long-term effects of polyacrylamide hydrogel on human breast tissue. Plast Reconstr Surg 111(6):1883–1890PubMedCrossRef

23.

Zhao Y, Qiao Q, Yue Y, Kou X, Liu Z (2004) Clinical and histologic evaluation of a new injectable implant: hydrophilic polyacrylamide gel. Ann Plast Surg 53(3):267–272PubMedCrossRef

24.

Leung KM, Yeoh GP, Chan KW (2007) Breast pathology in complications associated with polyacrylamide hydrogel (PAAG) mammoplasty. Hong Kong Med J 13(2):137–140PubMed

25.

Kasamaki S, Tsurumaru M, Kamano T, Kobayashi S, Hino M, Kuwatsuru R (2000) A case of inflammatory breast cancer following augmentation mammoplasty with silicone gel implants. Breast Cancer 7(1):71–74PubMedCrossRef

26.

Carlson GW, Curley SA, Martin JE, Fornage BD, Ames FC (1993) The detection of breast cancer after augmentation mammaplasty. Plast Reconstr Surg 91(5):837–840PubMed

27.

Schirber S, Thomas WO, Fimley JM, Green AE Jr, Ferrara JJ (1993) Breast cancer after mammary augmentation. South Med J 86(3):263–268PubMed

28.

Skinner KA, Silberman H, Dougherty W, Gamagami P, Waisman J, Sposto R, Silverstein MJ (2001) Breast cancer after augmentation mammoplasty. Ann Surg Oncol 8(2):138–144PubMedCrossRef

29.

Miglioretti DL, Rutter CM, Geller BM, Cutter G, Barlow WE, Rosenberg R, Weaver DL, Taplin SH, Ballard-Barbash R, Carney PA, Yankaskas BC, Kerlikowske K (2004) Effect of breast augmentation on the accuracy of mammography and cancer characteristics. JAMA 291:442–450PubMedCrossRef

30.

Peng DH, Liang MH, Liu LG, Gong JS et al (2006) Mammographic appearance of postoperative augmentation mammoplasty with hydrogel. Chin J Radiol 40(4):354–356 (in Chinese)

31.

Fajardo LL, Harvey JA, McAleese KA, Roberts CC, Granstrom P (1995) Breast cancer diagnosis in women with subglandular silicone gel-filled augmentation implants. Radiology 194:859–862PubMed

32.

Handel N, Silverstein MJ (2006) Breast cancer diagnosis and prognosis in augmented women. Plast Reconstr Surg 118(3):587–593PubMedCrossRef

33.

Leibman AJ, Kruse B (1990) Breast cancer: mammographic and sonographic findings after augmentation mammoplasty. Radiology 174:195–198PubMed

34.

Hou MF, Ou-Yang F, Chuang CH, Wang JY, Lee LW, Huang YS, Huang CJ, Hsieh JS, Lai CS, Lin SD, Huang TJ (2002) Comparison between sonography and mammography for breast cancer diagnosis in oriental women after augmentation mammaplasty. Ann Plast Surg 49(2):120–126PubMedCrossRef

35.

Wang HY, Jiang YX, Qiao Q (2007) Ultrasonographic value for the complications of breast augmentation with injectable polyacrylamide hydrogel technique. Zhonghua Zheng Xing Wai Ke Za Zhi 23(2):97–100 (in Chinese)PubMed

36.

Peng HL, Wu CC, Choi WM, Hui MS, Lu TN, Chen LK (1999) Breast cancer detection using magnetic resonance imaging in breasts injected with liquid silicone. Plast Reconstr Surg 104(7):2116–2120PubMedCrossRef

37.

Xu LY, Kong XQ, Zhang YM, Xu HB, Liu DX, Yu Q, Zeng J, Xiong Y (2004) Applications of magnetic resonance imaging in diagnosis of the complications after breast augmentation with polyacrylamide hydrogel injection. Zhonghua Zheng Xing Wai Ke Za Zhi 20(3):197–199 (in Chinese)PubMed

38.

Peng DH, Liu LG, Li S, Ma J et al (2005) Clinical and radiological appearance of postoperative augmentation mammoplasty with PAHG and its effect on imaging diagnosis. Chin J Med Aesth Cosmet 11(3):133–136 (in Chinese)

39.

Wang J, Shih TT, Li YW, Chang KJ, Huang HY (2002) Magnetic resonance imaging characteristics of paraffinomas and siliconomas after mammoplasty. J Formos Med Assoc 101(2):117–123PubMed

40.

Erguvan-Dogan B, Yang WT (2006) Direct injection of paraffin into the breast: mammographic, sonographic, and MRI features of early complications. AJR Am J Roentgenol 186(3):888–894PubMedCrossRef

41.

McIntosh SA, Horgan K (2008) Augmentation mammoplasty: effect on diagnosis of breast cancer. J Plast Reconstr Aesth Surg 61(2):124–129CrossRef

42.

Karanas YL, Leong DS, Da Lio A, Waldron K, Watson JP, Chang H, Shaw WW (2003) Surgical treatment of breast cancer in previously augmented patients. Plast Reconstr Surg 111(3):1078–1083PubMedCrossRef

43.

Carlson GW, Moore B, Thornton JF, Elliott M, Bolitho G (2001) Breast cancer after augmentation mammaplasty: treatment by skin-sparing mastectomy and immediate reconstruction. Plast Reconstr Surg 107(3):687–692PubMedCrossRef

44.

Handel N, Lewinsky B, Jensen JA, Silverstein MJ (1996) Breast conservation therapy after augmentation mammaplasty: is it appropriate? Plast Reconstr Surg 98(7):1216–1224PubMedCrossRef

45.

Jakub JW, Ebert MD, Cantor A, Gardner M, Reintgen DS, Dupont EL, Cox CE, Shons AR (2004) Breast cancer in patients with prior augmentation: presentation, stage, and lymphatic mapping. Plast Reconstr Surg 114(7):1737–1742PubMedCrossRef

46.

Gray RJ, Forstner-Barthell AW, Pockaj BA, Schild SE, Halyard MY (2004) Breast-conserving therapy and sentinel lymph node biopsy are feasible in cancer patients with previous implant breast augmentation. Am J Surg 188(2):122–125PubMedCrossRef

47.

Handel N (2007) The effect of silicone implants on the diagnosis, prognosis, and treatment of breast cancer. Plast Reconstr Surg 120(7 suppl):81S–93SPubMedCrossRef

Title: Breast Cancer Following Augmentation Mammaplasty with Polyacrylamide Hydrogel (PAAG) Injection
Authors: Ning-Xin Cheng
Li-Gang Liu
Li Hui
Yuan-Liang Chen
Shi-Liang Xu
Publication date: 01-07-2009
Publisher: Springer-Verlag
Published in: Aesthetic Plastic Surgery / Issue 4/2009
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI: https://doi.org/10.1007/s00266-008-9298-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Breast Cancer Following Augmentation Mammaplasty with Polyacrylamide Hydrogel (PAAG) Injection

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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