Breast Implants and Lymphoma Risk: A Review of the Epidemiologic Evidence through 2008

Background: In the past, concerns about lymphoma among women with breast implants have been raised by anecdotal observations. A recent report of a case-control study from The Netherlands reported an association of breast implants with anaplastic large T-cell lymphoma, but limitations inherent in the study design and the restriction of the association to saline implants preclude any causal evaluation. Methods: To determine whether lymphoma risk is in fact elevated in women with breast implants, the authors have reviewed the evidence from five long-term follow-up studies comprising over 43,000 women with cosmetic breast implants followed for up to 37 years, which reported results specifically regarding the incidence of non-Hodgkin's lymphoma, among other cancers. Results: Overall, there were 48 observed incident cases of non-Hodgkin's lymphoma compared with 53.9 cases expected, yielding a summary standardized incidence ratio of 0.89 (95 percent confidence interval, 0.67 to 1.18). None of the epidemiologic cohort studies reported a primary lymphoma originating in the breast. Conclusions: To date, there is no credible evidence of an increase of non-Hodgkin's lymphoma regardless of site or specifically originating in the breast among women with cosmetic breast implants. (Plast. Reconstr. Surg. 123: 790, 2009.)