New York, NY (February 4, 2004) — "Women who have undergone breast augmentation
can be reassured that, even though implants may interfere with routine mammography
evaluation, implants do not increase the risk of delayed cancer diagnosis," says
Leroy Young, MD, Co-chair of the Breast Surgery Committee of the American Society
for Aesthetic Plastic Surgery (ASAPS). Commenting on a recent study published
in the Journal of the American Medical Association ( JAMA ),
which concludes that breast implants make it harder to spot signs of breast
cancer during routine mammograms, Dr. Young says the study's most significant
finding is that augmentation patients diagnosed with breast cancer have a similar
prognosis for recovery as women without implants.

"While these two findings may seem contradictory," says Dr. Young, "the
researchers rightly point out that breast augmentation patients may be more
aware of their breast health, and therefore more diligent about seeking medical
evaluation when they notice any changes in their breasts. They also note that
breast implants may help patients manually identify unusual lumps or masses
in their breasts, and this may lead to earlier diagnosis."

The fact that the presence of breast implants makes it more difficult to effectively
visualize breast tissue on an x-ray means that mammographers should use special
techniques when examining women who have undergone augmentation. In addition
to "displacement," or pushing aside, of breast tissue, additional
x-ray views are necessary. However, the JAMA study found that women
with augmentation were no more likely to be called back for additional imaging
or breast biopsy than women without implants.

The American Society for Aesthetic Plastic Surgery, the leading society of
board certified plastic surgeons specializing in cosmetic surgery, offers the
following guidelines for women who have undergone breast augmentation:

Mammography Guidelines for Augmentation Patients

• Mammograms should be performed by technicians with experience in the displacement
  techniques required for better x-ray views of breast tissue.
• The presence of implants should be noted when making the appointment and
  again at the time of examination.
• Regular breast self-examination is useful and may be particularly effective
  as a method of early tumor detection when breast implants are present.
• Ultrasound is another technology that is highly useful in breast cancer
  detection.
• Magnetic resonance imaging (MRI), although expensive, provides the highest
  degree of accuracy and is unaffected by the presence of implants.
• Mammography
  is encouraged: for women over 40, every one to two years, according to
  guidelines from the American Cancer Society.
• Women with breast implants are encouraged to visit their plastic surgeons
  on an annual basis for routine examination.

The JAMA study showed that mammography alone missed 55% of the cancers in
asymptomatic women with augmentation and 33% in similarly aged women without
augmentation.

The information that breast implants can partially obscure mammograms is not
new, nor is the finding that breast augmentation patients, overall, are not
diagnosed for breast cancer at a later stage than other women. There are other
scientific studies supporting similar conclusions, as well as some that have
suggested later-stage diagnosis of augmented women. A 2001 study by the National
Cancer Institute of 13,500 women with breast implants found that there was
no increase in breast cancer, no increase in breast cancer mortality, and no
breast cancer detection delays. A study of 3182 augmentation patients in Los
Angeles County showed no delay in breast cancer detection and a significantly
lower than expected risk of breast cancer after an average of more than 14
years with breast implants.

“The finding that augmentation patients overall appear to have a lower rate
of breast cancer than other women certainly deserves further research," says
ASAPS President Robert Bernard, MD, of White Plains, NY. "While we don't
yet know what factors may be involved, future studies may yield important information
that can benefit all women."

Further Information on Mammography and Breast Implants:

Miglioretti, et al: Effect of breast augmentation on the accuracy of mammography
and cancer characteristics. JAMA , January 2004. 2004—Vol 291, No.
4

Status of Research at the National Institutes of Health, NIH Report to Congress,
May 2003. National Cancer Institute Project: Follow-up of women with augmentation
mammaplasty, project ID: Z01-CP10128, Study #42-92-00.

National Academy of Sciences Institutes of Medicine: Breast implants: status
of research at the National Institutes of Health, May 2003.

Berg, et al: Single and double-lumen silicone breast implant integrity: prospective
evaluation of MR and US criteria. Radiology. 197:45, 1995.

Brinton L.A., Breast cancer following augmentation mammaplasty ( United States
). Cancer Cause Control . 9:819, 2000

Brown, Silverman, Berg: Rupture of silicone-gel breast implants: causes, sequelae,
and diagnosis. Lancet. 350:1531, 1997.

Deapen, Hamilton, Bernstein Brody: Breast cancer stage at diagnosis and survival
among patients with prior breast implants, Plast Reconstr Surg 2000;
105:535-540

Deapen, Bernstein, Brody: Are breast implants anticarcinogenic? A 14-year
follow-up of the Los Angeles study. Plast. Reconstr Surg . 1997-99:
1346-1353.

Gutowski: Saline-filled breast implants: a Plastic Surgery Educational Foundation
multicenter outcomes study. Plast Reconstr Surg. 100:1019, 1997

Hadden. Silicone breast implants: a review. Australas Radiol. 42:296,
1998.

Handel, Silverstein, Gamagami, et al Factors affecting mammographic visualization
of the breast after augmentation mammaplasty, JAMA , 1992, 286:1913-1917.

Silverstein, Handel, Steyskal, et al: Breast cancer in women after augmentation
mammaplasty Archives of Surgery , 1988, 123:681-685

Silverstein, Handel, Waisman, et al: Augmentation mammaplasty with silicone
gel-filled implants: its effect on breast cancer diagnosis. Proceedings
of ASCO , Vol. 8, March, 1989

Silverstein, Handel, Gamagami, et al: mammographic measurement before and
after augmentation mammaplasty. Plastic and Reconstructive Surgery ,
1990; 86:1126-1130

Strom, et al: Cosmetic saline breast implants: a survey of satisfaction, breastfeeding
experience, cancer screening, and health . Plast Reconstr Surg. 100:1553,
1997.