Friday, April 24, 2009

Never Having to Wear A Bra Again

October is Breast Cancer Awareness Month. It is an important time to inform and educate everyone—men and women—about breast cancer detection, prevention, and treatments. Yesterday, the Oprah Winfrey show dedicated its hour to this very topic. The show began with Christina Applegate bravely sharing her story. I applaud her openness and Oprah’s dedicating her show to this issue. Christina discussed her decision to have a radical mastectomy and her decision to be reconstructed with saline implants. She explained the procedure of getting saline implants after mastectomy, the placement of breast expanders, and the later implantation of saline implants. She then said “I’ll never have to wear a bra again.” That took my breath away for a second.

My mother went to the Mayo Clinic in the early 1970’s and she was told to have a radical mastectomy and have her breasts reconstructed with silicone implants. Her surgeon told her the same thing--“You’ll never have to wear a bra again!” Two years after that surgery her implant ruptured and she had it replaced. Very shortly after that it ruptured again. My mother has suffered a great deal of pain from the several surgeries, complications from the implants, and subsequent health problems. Not having to wear a bra was a very insignificant benefit given the many serious problems she had with her implants.

Now, one might say that this happened years ago and now implants are safer, the surgery has been perfected, and even the FDA has approved both saline and silicone implants. I think this is far from the truth. Somehow, the known risks, the known complications, and unknowns about the long-term safety of both saline and silicone implants are being lost. Don’t forget that the FDA and implant manufacturers fully acknowledge that breast implants carry known risks, like rupture and capsular contracture. The safety dispute emerges regarding the “unknown” risks like severe allergic reaction to the chemicals and platinum salts used in both saline and silicone breast implants.

I watched the Oprah show yesterday and by the end of the hour I was filled with a profound sadness and anger that I didn’t hear any discussion about the safety of implants. There was not even one word mentioned about risk or safety questions. And, breast implants, both saline and silicone, are only one of the reconstruction options for mastectomy patients. There are other reconstructive procedures available to women, using the patient’s own fat (from other areas of the body) to rebuild the breast. Or, there are some very gifted medical artists who sell breast prosthesis that require no surgery. Visit New Attitude Inc. for more info on this...

On yesterday’s show there was an oncologist, the head of the Susan Komen Foundation, and several breast cancer survivors. The conversation was important and informative but missing an important chapter—other options that may be safer and perhaps even less expensive for women.

Today, I went to the Oprah website hoping to find some supplementary information about the safety of breast implants and it wasn’t there. I am so struck by the seeming lack of information presented to women and to the public. There are important organizations that every woman facing this choice should contact.

Judy Norsigian, the Executive Director of Our Bodies Ourselves, has stated “We know breast cancer patients want to make informed decisions, but that just isn’t possible when the necessary long-term research has not been done.”

Breast Cancer Action has a statement about the FDA approval of silicone implants, “Breast Cancer Action is alarmed and concerned that the FDA has once again erred on the side of industry at the expense of women’s health.”

The National Center for Research for Women and Families issued a report in 2006 called Decisions in the Dark. Do breast cancer patients choosing silicone implants know that Inamed Corporation’s three year study on silicone implants that 46% of the reconstruction patients had a re-operation in the first three years? Do they know that Allergan, one of the leading sellers of breast implants today, states in all of their ads “Safety and effectiveness have not been established in patients with a weakened immune system.” And, that “The health consequences of a ruptured silicone gel-filled breast implant have not been fully established.”

Where is the balanced information so that women can make an informed choice? I applaud Oprah and Christina for talking about breast cancer and mastectomy, but such discussions must at least acknowledge that breast implants carry known and unknown risks. Never having to wear a bra again is the least of our concerns.