Is implant removal necessary for breast cancer surgery?

Last Modified: October 5, 2003

Dear OncoLink "Ask The Experts,"
I was diagnosed with stage 1 invasive ductal carcinoma in my right breast. I have already had a lumpectomy and now have to go for a wedge excision and lymph node axillary dissection. I have had saline breast implants since 1994 and my surgeon is concerned about the wedge excision surgery and the implant - mainly because he feels he won't be able to close the incision without a "cosmetic defect" and also that he fears he may come close to the implant and risk damaging it. He wants me to adjust my consent form to include possible removal of breast implant. I am deeply concerned that this is not 100% necessary - I realize that my health and recovery is most important but need to obtain more information regarding alternatives to removal. Any information you can provide to assist me in making a fully informed decision prior to my surgery would be greatly appreciated.

Don LaRossa, MD, Professor of Surgery at the University of Pennsylvania Medical School, responds:

This is a complex issue. Her surgeon's mission must be adequate surgical removal of her breast cancer. There is no way to 100% certain that the implant will not have to be removed either because it is injured in the process of the surgery or the surgeon may not be able to close the skin. My recommendation would be to involve a reconstructive surgeon before the surgery is undertaken. He/she can review the options with the patient and proceed with the best approach depending on the situation following the removal the breast cancer. The solution may be complex such as movement of flap tissue from the back or abdomen and needs careful discussion before the surgery is undertaken.