The impact of breast cancer on cosmetic breast augmentation outcomes and screening challenges in patients with implants: a literature review.

Abstract

Background and objective: Breast augmentation remains one of the most common aesthetic surgical procedures worldwide, offering significant psychological benefits. However, the presence of breast implants introduces unique challenges in oncologic safety, particularly in cancer screening, diagnosis, and long-term surveillance. This literature review evaluates the impact of breast implants on breast cancer detection, prognosis, and the evolving management of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), alongside recent developments in postmastectomy radiation therapy (PMRT) and implant-based reconstruction.

Methods: A search was conducted in March 2025 across PubMed, Cochrane Library, and SciELO. Studies in English or Portuguese addressing breast cancer screening, outcomes, or BIA-ALCL in patients with breast implants were included. Data were charted on study design, implant type, imaging strategy, cancer outcomes, and BIA-ALCL diagnosis and treatment.

Key content and findings: Of 447 initial records, 62 met inclusion criteria. Evidence confirms that breast implants do not increase breast cancer incidence or worsen prognosis. However, implants-especially subglandular-impair mammographic sensitivity, potentially delaying diagnosis. The Eklund technique, magnetic resonance imaging, and ultrasound significantly enhance screening efficacy but remain underutilized. BIA-ALCL, an uncommon malignancy linked to textured implants, demands heightened clinical awareness, standardized surveillance, and prompt en bloc capsulectomy when indicated. Innovations in reconstructive protocols now allow safe use of implants in irradiated patients through approaches such as delayed-immediate reconstruction and lipofilling.

Conclusions: Although breast implants do not elevate cancer risk, they complicate screening and may delay detection. Optimized imaging protocols and patient-specific screening strategies are essential. BIA-ALCL underscores the importance of informed consent and long-term monitoring. Advances in PMRT compatibility with implants are improving reconstructive outcomes. Multidisciplinary care, patient education, and global standardization are key to improving oncologic safety in augmented populations.