Sunday, November 3, 2013

The Downside of Implants

CUTAG of the Week:


Extensive research has shown that a mutation in the gene HER2, along with other genes, can increase one’s likelihood of developing breast cancer. Recently, many women who have discovered that they carry this mutation have gotten single or double mastectomies, in hopes of decreasing their cancers of developing breast cancer. Many women, after undergoing such procedures, may receive breast implants. With current evidence showing that breast implants may make it much more difficult to detect breast cancer at its early stages and thus make it harder to treat, do you think that women with the genetic predisposition to develop breast cancer should be discouraged from getting implants? If it is found that implants are in fact a direct cause of breast cancer, should a debate be started in perhaps stopping breast implant procedures?

67 comments:

  1. I do believe that more research should be put into this study and a debate about breast implant procedures should begin if they do seemingly cause cancer. However, I think it would be hard to get people on board to completely stop all cosmetic breast enhancement surgeries because of the correlation with cancer. Smoking cigarettes is a known cause of lung cancer and the second hand smoke from cigarettes is a cause as well, however cigarettes have not been outlawed. Cigarettes are much more common than breast implants (I would assume), yet all law makers do is raise the prices. I think women who have the genetic predisposition for breast cancer should fully understand what they are doing when they opt to get breast enhancement surgery and there should be more research for this, but I just don't think it would be possible to outlaw breast implant procedures.

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  2. The decision to have a single or double mastectomy whether prophylactically or as treatment is a very difficult decision women have to make because of the very visible physical effects. Breast reconstruction is a very important option for women who wish to restore their femininity or sense of normal. Like all procedures, there are inherent risks, which should be weighed and discussed with each woman's doctor. I think we should investigate further how implants may obscure breast cancer screenings. However, unless a patient is not a good candidate, implants should not be discouraged. The doctor-patient relationship should be emphasized so informed decisions are made and every patient has the support they need.

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  3. According to the reading, we can infer that breast implants or something about breast implants adversely affects a woman's body. Although they strongly suggest more research should be done, we do know from their observational studies that this correlation, if proven to be true, is an extremely frightening fact.

    Despite having breast implants being a personal choice, I believe that we lack knowledge in this topic and we need to put more time and effort to see if this is true. Although it is not a marketable idea, since breast implants is a norm of Hollywood, if scientists or doctors are able to prove a correlation with cancer and breast implants perhaps some people will think about actually getting implants.

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  4. Elisabeth BellissimoNovember 3, 2013 at 6:55 PM

    As we saw in the film, In The Family, deciding whether or not to go through with a single or double masectomy after finding out about having an increased risk for breast cancer is an extremely difficult decision for most women to make. Many women, such as Angelina Jolie, who choose this surgery do it knowing that they can get a reconstructive surgery after in order to restore what they have lost of their womanhood. However, this article has opened my eyes to the possible danger associated with breast implants. I think that doctors have a duty to explain to their patients the risks associated with breast implants, but I think that more research needs to be conducted in order for doctors to actually discourage women from getting implants. But I absolutely believe that if a direct cause was ever found between breast implants and cancer, the procedures should be stopped, and other options should be explored. Unfortunately, this will probably make the decision about whether or not to get a masectomy procedure even harder, but if breast implants are proven to be directly causing adverse effects, they need to be stopped altogether.

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  5. I think much more research and evidence should be found before women who are genetically predisposed to breast cancer should be discouraged from getting breast implants. And unless it is proven fact that getting breast implants dramatically increases later detection of cancer there should be no debate making it so women cannot breast implants. Even with this evidence I do not think discourage is the best word. I think women should be informed of all the facts without bias and then be allowed to make their own decision. A double mastectomy is an extremely emotional procedure and can lead women to feel less feminine so if they wish to receive breasts implants while fully informed of the risk I think they should be allowed to.

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  6. Obviously, there needs to be more research on this topic before doctors can start discouraging their patients from getting breast implants. If there are more consistent studies showing that breast implants make it harder to detect breast cancer, then yes, women with a genetic predisposition should be warned. However, women who are willing to go under the knife and bear the risks of getting implants obviously have strong feelings towards getting the implants, so a simple warning might not be very effective. This is especially true with women who have already had their breasts removed and want reconstructive surgery to replace something that is almost essential to feeling like a woman.

    In the event that there is evidence that implants are a direct cause of breast cancer, I do not think there should be a debate about stopping procedures all together. If it was a high risk, then yes, stopping the procedures should be considered. But people do things that could contribute to the development of cancer (or other diseases) all of the time! Smoking, certain habits and living in certain areas all contribute to the development of cancer or another health problem. Not allowing women to go through with a procedure that would make them happier and more confident wouldn't seem fair when people are allowed to purchase cigarettes.

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  7. Although several recent scientific studies have concluded that breast implants make it more difficult to detect and diagnose breast cancer at its early stages, and therefore more difficult to treat, it is apparent that a good amount of uncertainty and fear of potential bias surrounds these results. Due to the fact that undergoing a double mastectomy can be an extremely emotional and life altering experience for a woman, such controversial evidence should not be viewed as a reason to discourage these woman from getting breast implants and thus, the opportunity to regain a sense of normalcy and renew their self confidence. However, if future scientific evidence is able to prove a direct correlation between breast implant procedures and breast cancer, I do think that all breast implant procedures should end in all women whether they are at an increased risk for breast cancer or not. If we are able to prove that a certain medical procedure greatly increases a patient's risk for a deadly disease such as cancer, I can't imagine any way to ethically justify allowing a person to undergo that particular procedure.

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  8. I think that special attention should be put into more research on breast implant procedures and their ability to make it more difficult to detect breast cancer at its early stages. Having the breast implant procedure done is entirely elective, and therefore if this information is backed by more scientific evidence, I think that the people will generally become less willing to choose to have it done. I think that there needs to be more information in order for women to be discouraged. Without more knowledge on the topic, there can’t be any unbiased decision made to have the procedure or not.

    In the future if there are more conclusive studies done to find that there is a direct correlation between cancer and implants, I think that woman with the genetic disposition to develop breast cancer should be discouraged from getting the procedure without question.

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  9. The fact to pull from this research is that further study is needed. I think that it's very important to realize that there hasn't been any adjusting for confounding error. That being said, maybe there is another factor that is currently unseen which explains the rise in breast cancer rates in women with implants as opposed to women without.

    In terms of keeping women who get mastectomies from breast implants, that would be up to them. These women are presented with a choice when diagnosed with a gene that gives them a predisposition for breast cancer. They're given the percentage by doctors about their likelihood, and then the choice is theirs. I don't see why getting breast implants is any different. You know the risk, and the choice is yours. What's needed is more research to give a truly accurate percentage, so that women can make the most genuine decision they can.

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  10. I think it is to early to begin discouraging women from obtaining breast implants after undergoing single and double mastectomies. It more repeated research indicates that breast implants truly impede discovery of early stage breast cancer then doctors and genetic counselors should present the facts to help their patient make an informed decision. Additionally, increased education for physicians is needed to allow them to know when to advise for preventative measures such as elective mastectomies and more referrals should be made to genetic counselors who are better equipped to advise and support an individual with genetic predispositions for breast cancer. This would prevent unnecessary surgeries for those not at significant risk.

    However if breast implants were found to directly cause breast cancer then it would be obvious that physicians should advise against such cosmetic procedures, and I am sure many women would agree. More research and innovation should be pursued for breast implants that do not inhibit the function of MRIs so that women who do elect to have mastectomies can have the choice to have the implants.

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  11. I think that if a woman has already removed her breasts to reduce her risk of breast cancer than I do not see the issue with implants. Yes, they could hide potential tumors which is a risk, but at the same time, how high is that risk once the breast tissue has been removed? If the risk drops to below 5-10% then they would have about the same risk of getting breast cancer as any other woman out there, so I do not think special consideration should be given to getting the implants. If the risk was still high after the breast tissue was removed then yes, I think serious consideration should be given before getting implants if they could mask developing tumors. I do not see how implants can cause breast cancer but if it was somehow found to be the case then I think a new type of implant should be developed that has a zero risk.

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  12. In order to fully understand how breast implants affect breast cancer more research must be done. While researchers further investigate the impact of breast implants, doctors should continue to inform women seeking to receive implants the risks of not being able to detect breast cancer at its early stages. The main point to recognize in this article is that many of the studies used to form this statement that breast cancer is not well detected in women with cosmetic breast implants did not adjust for potential confounding factors. This is important to note as confounders have the potential to significantly effect the results of a study. If future studies conducted adjusted for potential confounders and still showed an adverse relationship between early detection and breast implants, I do not believe it will be correct to ban breast implant procedures. There are many things that men and women do that contribute to the development of cancer, like smoking for instance, and they are aware of the possible detrimental effects of their actions. Or on the other hand not even getting screened for a cancer at all. As long as women are informed of the risks and able to make a well-informed decision, they should have the right to do what they want with their bodies, even if it does increase the possibility for not detecting breast cancer.

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  13. I think this decision should be completely up to the individual. In Angelina Jolie's case, the risk of getting breast cancer went from over 80% before having a double mastectomy to less than 5% after having the double mastectomy. That being said, even though it's harder to detect the breast cancer, individuals are at least 16x less likely to get breast cancer at all. If one feels as though she should not get implants after because of this, then that is very respectable, however, every woman is different. Many feel as though their physical feminine characteristics have been removed completely and have a hard time overcoming this without implants, and I also think that is respectable and I feel as though I would feel the same way. Other woman are able to feel completely empowered either way and don't need implants to feel that way, which is also respectable. This is a debate that I believe should be completely up to the individual. It's a matter of feeling empowered and feminine and I don't believe medicine or the government should have the ability to overrule these women's decisions.

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  14. I think that deciding to get a single or double mastectomy is a very tough and emotional decision for a women who has a predisposition to breast cancer. Eliminating the ability for women to get breast reconstruction or implants may make the decision to get a mastectomy in the first place even harder. Women who have a mastectomy may feel like their femininity, self-confidence, and sense of "normalcy" may be diminished. Access to breast reconstruction surgery allows these women to gain back their sense of womanhood. If you eliminate implants all together, women may be less likely to get mastectomies, therefore, these women would have a higher risk of getting breast cancer then if they got the mastectomy and then implants. However, I do believe that more research should be done on the topic, where cofounding factors are accounted for to see if the correlation really does exist. If that is the case, then I do think it is important to investigate in alternatives for breast implants, but I also think it is important to keep the option for breast implants out there. I think the woman should be able to make an informed decisions by taking into account the benefits versus risks and deciding what she thinks is best for her.

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  15. I think that this study brings up an interesting point but there should definitely be more research to find out exactly what breast implants mean for a woman with a predisposition to breast cancer. The article itself says that the study didn't take into account any confounding factors, which means that the implications of this study should be taken lightly until more research can be done.

    I believe that getting a mastectomy is a big decision for a woman. It is extremely personal and trivial, and there are many factors to take into consideration. It can take away a woman’s femininity and dignity. I think that the option of reconstruction is a big factor for a woman when making the decision because it can give back the lost sense of femininity. I think that if reconstruction was limited as an option, less woman would be likely to get mastectomies and therefore their risk would still be high. Overall, I think this study brings up a good point but more research definitely needs to be done.

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  16. While this is new news to me, I don’t find it particularly shocking that breast implants hinder the ability to detect breast cancer. Therefore, I think women should be privy to this fact and be given, maybe even strongly advised, the option to test for the gene to ensure a low chance. If the person were to be positive and at a high risk for breast cancer then it would be up to the discretion of the patient and doctor to decide if they should go through with the implants. In general this is a fact that should be made widely available at the surgeons office so people are aware of the risk they are entering themselves in. However, im sure this would be very controversial because I imagine the doctors would be concerned about losing businesss.

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  17. The study analyzed brings up an important deciding factor when opting to choose breast implants after a mastectomy - the potential obscuring of early stage breast cancer tumors by the implants. However, mentioned in the article is how the study does not adjust for confounders, thus meaning more research is necessary before drawing conclusions. As well, there are other deciding factors that go into this situation - one's breast cancer risk after surgery, epigenomics and the environment, how much support is received, health insurance coverage, etc. This article only focuses on one aspect of the picture when in reality, there are a lot more sides to consider.

    In terms of whether or not a woman should receive implants after a mastectomy is ultimately her decision. She is the one to look at the pros and cons of each informed option and then decide what is best for her. With support, and hopefully better future research and evidence about breast implants, a confident choice can be made. She can use this article and further ones to help in her decision, but should also take into consideration other research and contexts.

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  18. As the article suggests, the findings of the studies should be scrutinized and thoroughly assessed before any valid conclusions can be drawn. The current evidence associating breast implants with an increased risk of cancer seems to be inconclusive and therefore, unreliable. Consequently, I do not think women with a predisposition for breast cancer should be discouraged from getting implants, especially after getting a preventative mastectomy. Being proactive and getting a mastectomy is an immense decision to make even though it reduces the chance of developing breast cancer by over 75%. Furthermore, women rely on the option of breast implants post-mastectomy to restore their femininity. I do not think any information regarding a potential correlation between implants and breast cancer should be exposed until the evidence is thoroughly reviewed and validated. If the correlation does indeed exist, women should be warned of the risks surrounding implants so they are able to make an informed decision.

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  19. I think it is really important to take into account the fact that these finding are inclusive and do not take into account factors like confounding. For many women who have a strong genetic predisposition to developing breast cancer, undergoing a mastectomy is the only option available that can significantly decrease that risk. As we saw in “In the Family,” this is an extremely difficult and emotional decision. For many women, deciding to get breast implants may be a decision made in an attempt to return to a sense of normalcy that they had before the surgery. While I feel that women should take this finding into consideration (particularly when more studies are done and more substantial conclusions can be made), I do not feel that women with a genetic predisposition to develop breast cancer should be discouraged from getting breast implants at the time. If it is later discovered that breast implants are in fact a direct cause of cancer, than I feel that women should be made known of the risk so that they can make an informed choice. Many people engage in behaviors that are known to directly cause different forms of cancer, such as tanning and smoking, but they are not completely prohibited and I feel that the same could be true for breast implants.

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  20. Although this topic needs more research, I think it is important to note the relationship between getting breast implants and being able to diagnose cancer at an early stage. If the woman were to know that she had a genetic predisposition to develop breast cancer, I definitely believe that she should be fully informed about her risks, but not necessarily discouraged. Deciding to get a breast implant can be a very sensitive issue for a woman, and should be her decision as long as she is aware about the risks. If enough research has proven that implants are in fact a direct cause of breast cancer, this would most likely spark a debate about breast implant procedures.

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  21. Although this article provides some interesting developments in research and information, I don't think the scientific would is ready to make a statement about if women should/should not be allowed or concerned about putting in breast implants post masectomy. The article is not yet conclusive, but does show that there may be an importance in having women be informed of the potential risks of getting implants in not being able to detect breast cancer early.

    That being said, a woman's risk of getting further breast cancer should greatly decrease after a masectomy. More importantly, it's a personal decision if a woman wants to get implants or not. They shouldn't feel discouraged to do what they wish, as long as they are well informed of the procedure's risks and benefits.

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  22. This article provides an interesting perspective on the potential risks of later detection of breast cancer development due to breast implants. The article states that having breast implants makes early detection more difficult and because of this"women with cosmetic breast implants had a 26% increased risk of being diagnosed at a later stage of breast cancer than women without breast implants". However, the article also states that "these findings should be interpreted with caution" as the impact of cosmetic breast implants on later detection of breast cancer is still being research. I do not think it is safe to assume that cosmetic breast implants should not be allowed to women who have a high risk for developing breast cancer. Obtaining cosmetic breast implants is the choice of the women, who should be well informed of the risk and benefits of something like implants. Having a mastectomy does greatly reduce one's chance of developing breast cancer, as we read in the Angelina Jolie article where her risk dropped fro 87% to 5% after having a preventative double mastectomy. With that being said, more research and concrete results must be studied and released before patients and doctors both assume that having or not having cosmetic breast implants will or will not increase once's risk for detecting a later stage of breast cancer.

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  23. The study does state that the findings should be interpreted with caution, and it's only an increased risk of detecting breast cancer at a later state. I think at this point in time, it's not the biggest concern. Until there is more concrete evidence, I don't think women should be any more worried than they already are about breast cancer. I understand getting a mastectomy to reduce the risk of cancer, and if implants increase the risk of missing detection, then that seems counterproductive and women should take that into account when they decide for or against implants. They should be advised and not discouraged by professionals though because their autonomy must be respected. However, if it is determined that breast implants cause cancer, then most sensible people will turn to different options or avoid it altogether without officials having to eradicate the procedure.

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  24. While the study emphasizes that the current conclusions are still tentative, it is an unfortunate notion that breast implants could potentially be counter productive to mastectomy. If the study proves to be correct and breast cancer increases the chances of failing to recognize breast cancer until later stages, alternative options will probably become under scrutiny or devised. Either the breast implant procedure will be modified, or diagnostic tests will have to be altered to identify breast cancer despite having implants. However until alternative solutions are found and breast implants are proven to definitely increase the risk of breast cancer, I believe breast implants will continue to be used as an option before and after double or single breast mastectomy. Furthermore it is important to emphasize that the study is still inconclusive. It is good that the researches emphasized this point and did not try to twist things out of proportion, similar to how the "cheating gene" was blown out of proportion.

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  25. The article starts of with a disclaimer in big bold letters saying that the authors warned about interpreting results because they did not adjust for potential confounding factors. That disclaimer make me question the validity of the research in general. For women that have the genes that put them at a heightened risk for breast cancer, mastectomies(at this point in time) are the only viable option that will greatly reduse their risk for breast cancer. That option is a hard one to choose and getting breast implant can help them cope with that challenging discussion. If there is in fact an increased risk of getting breast cancer from implantation, women should be made aware of that risk, so they know what they are getting them selves into.

    As far as restricting cosmetic breast implants because they may slightly risk of late diagnoses or treatment, I think it is ridiculous to prohibit cosmetic implants. If women want bigger breasts, let them have big boobs. Who are we to get all paternalistic? As long as its legal and they are not hurting anyone else, let people do what they want. Before getting a breast implant a woman should be made aware of the risks, but it should be her choice to do it. I guess one could argue that if big boobs become a norm, then people without big boobs who don't have the means to get implants are at a disadvantage. But that is a whole other ethical argument about the pros and cons of enhancement procedures.

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  26. Normally, I would agree that breast implants are a bad idea, however individual circumstances should be taken into consideration. For example, I would not recommend a healthy woman to get implants if it’s simply for cosmetic purposes. With this new research, it seems like a risky choice. Since breast cancer is somewhat common, undergoing a procedure that could possibly delay or inhibit diagnosis does not seem like a smart idea. Personally, I would not take the risk. If I were to develop breast cancer I would not want to undergo a procedure that is responsible for hindering or hiding the cancer detection.

    On the other hand, women who have already undergone a mastectomy are a different story. If breast cancer has already been detected and removed, getting implants could be beneficial. For most women, undergoing a double mastectomy and dealing with the aftermath is a very psychological and emotional event. Getting implants make many women feel better about the situation, and give them a sense of feeling “normal.” However, women who receive these implants should still continue to be closely monitored in case the cancer happens to reemerge. In the end, we still need to take this information with a grain of salt, especially since these research results did not lead to definitive conclusions.

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  27. I do not think that women with this genetic predisposition should be discouraged from getting implants. However, I think that women should be informed about the possibility of the risks associated with breast implants after a mastectomy.
    One of the most important things, I think, to take away from this short piece is that the research did not account for confounding factors. This is a huge statement! While there is an association based on what evidence there is, it is most certainly not conclusive and in my opinion is not valid or strong enough to base any clinical advice off of.
    For women who undergo a mastectomy, they are not only already significantly reducing their chances of developing breast cancer, but they are also undergoing a huge emotional process. It is quite possible that the only reason many women do get a mastectomy is because they know they will be able to get breast implants and allow them to retain some normalcy in their pre-cancerous/cancer-free lives.
    Like I already said, we are a far ways away from showing that there is a direct link between breast implants being a cause of breast cancer. However, in the hypothetical that there is a causal link, I think it will be important to determine what the increased risks of having the implants are compared to the decreased risk of getting a mastectomy. If there is still significant decrease in risk for having a mastectomy and implants as compared to no procedures at all, then I think that the cessation of implantation procedures will not occur.

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  28. I think that women who know they have the genetic predisposition to develop breast cancer should be made aware of possible outcomes of getting breast implants, but in the end of course it is that person’s decision. I think these women should be given this information because it is important in going forward with decisions. Although there are still other confounding factors, which are not necessarily accounted for, women should still know that this discovery has been made. If implants are found in fact to be a direct cause of breast cancer, I’m sure a debate would take place regardless; however, I don’t think it should be prohibited. Women should know what their options are. I’m sure many would choose to not get implants with this kind of information known to them because it’s safer for their future health. Now after saying all this, I’m realizing that there is an ethical issue for something like this. Is it ethical to continue doing breast implant procedures knowing that it could directly cause breast cancer? I would say no, if it is fully proved to be a direct cause, because doctors would feel guilty potentially increasing a woman’s chances of developing breast cancer.

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  29. This is a very tricky topic, and will likely create a lot of debate as knowledge of this discovery widens. I believe that it is incredibly important for women to have the comfort of being able to feel feminine thru breast implants after undergoing a potentially traumatic surgery. Of course, women shouldn't be made to feel like they need breast implants to feel feminine, and should receive the counseling that they need to understand all of their options post-surgery in feeling comfortable with themselves.

    However, it's important to understand the health implications of breast implants in terms of catching cancer. Women should know, of course, when they go in for implants that it will be difficult to find cancer. They should be made to know all of their alternatives, and give proper, narrow consent to the surgery. However, I believe that the solution lies in improving technology to be able to catch cancer thru the implants, but also in coaching women to find other ways to feel comfortable with their bodies after their surgery. But we cannot, as a community, take away something that many women see as comforting after undergoing a brave and traumatic experience.

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  30. There seems to be a lot of ambiguity surrounding the results of this article. Nothing is very clear-cut and there isn't much information given about how or what type of past studies were analyzed. They also say that confounding factors were not taken into effect so the results may be very skewed.

    That being said, I think it's important that women continue to have the option of getting breast implants. I think that just like any other procedure, they should be well informed of all of the pros and cons before they follow through with it. If implants really do increase the likelihood of developing breast cancer, then the physician should be sure that the patient knows this and that she has completely thought it through before agreeing to get implants.

    I think it's very clear that much more research is needed before any giant steps are taken. Confounding factors realized, if implants are proven to cause cancer than it should be treated the same way as cigarettes and other cancer-causing objects are treated. There should be many warnings and the whole population should be aware of the possible consequences. As of now, I don't think it would be plausible to make too big of a deal out of it. In a nutshell, I agree with the majority of my peers on this one.

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  31. I agree with everyone who said that there should be further investigation in this study; hence the article itself says there are limitations. Even though there is evidence showing that breast implants may make it much more difficult to detect breast cancer at its early stages, the risk of getting breast cancer after mastectomies (either single or double) is still very low. It is already hard for the women to decide whether they should get the surgery or not, and knowing that breast implants will make it hard to detect breast cancer in the future will only deter their decision of getting surgery in the first place. I believe that the physician should not discourage breast implant procedures but they should explain to their patients that the risk of developing breast cancer in the future is very low after surgery but breast implants might make it harder to detect breast cancer if they were to develop it. Then it should be the patient’s decision whether or not they want to get the implants.

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  32. First off, the article itself called for caution because the research did not factor in confounding factors, so that opens the door to a lot of other possibilities of things that might have not been accounted for.
    As far as what to do in regard to breast implant suggestion, I think that there definitely needs to be more research done to accurately depict what is the actual result of breast implants, and how it relates to cancer, the detection of cancer, and prognosis. If it is found that implants make it difficult to detect early stage cancer, there should be a way of reporting this data to women who are considering getting them. I think that women should be advised about how this can affect them, but as with all other discussions we have had, the final decision is up to the patient. It is up to the patient to weigh the pros and cons of all possible treatments and therapies.
    This concept is much more relevant if in fact research determines that breast implants lead to an increased risk of cancer. In this case it can be suggested that women seek other alternatives, but again the choice is ultimately up to the individual person. People choose to smoke, drink and drive, and other detrimental things, so we can only attempt to regulate actions and inform them on what the data states.

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  33. With current evidence showing that breast implants may make it much more difficult to detect breast cancer at its early stages and thus make it harder to treat, do you think that women with the genetic predisposition to develop breast cancer should be discouraged from getting implants?

    I believe that if a woman has gone through the difficult decision and procedure of a preventive double mastectomy, she should be vehemently discouraged from getting breast implants which would then increase her risk of death due to breast cancer to 38%. Although I can understand the desire to have one’s breasts reconstructed after a double mastectomy, I don’t believe that a doctor should encourage his or her patients to do something that can undo their brave decision to undergo a double mastectomy. That said, it is ultimately the choice of the patient, so doctors should be supportive and dedicated to carrying out the patient’s wishes once a decision has been made by the patient.

    If it is found that implants are in fact a direct cause of breast cancer, should a debate be started in perhaps stopping breast implant procedures?

    If breast implants are indeed found to be a direct cause of breast cancer, I believe the risks should be communicated to those interested in having the procedure done, but I absolutely do not think that a debate should be started as to whether breast implant procedures should be stopped entirely. I believe that every human has the right to do whatever they choose to their own body, and I therefore believe that a debate as to whether breast implant procedures should be banned across the board would violate the rights of many women who wish to augment their body in this way.

    Shanika Gilmour

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  34. If there is indeed evidence that breast cancer is harder to detect with breast implants, then that increased risk should be communicated with women who could potentially be affected. However, I still think the decision is ultimately up to the patient, and each woman should be able to exercise the right to have implants if she so chooses. A mastectomy is a serious, life-changing and also life-saving procedure, so potential side effects or other possible risks should definitely be known but for some women, the benefit of having "regular" looking breasts instead of nothing outweighs the risk of not being able to detect reoccurring tumors. Physicians should be supportive of the patients' desires, especially in such an emotional time in their lives.

    In the case that there is complete evidence that breast implants indeed directly cause breast cancer, then I think a debate about potentially stopping breast implant procedures would be legitimate. If it's a matter of saving many lives by reducing that risk, then I think it's worth having a serious conversation with these women about why exactly they want the implants and what kind of risk they are willing to take.

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  35. The decision to get a single or double mastectomy is not a light one to make, as we saw from the video in class. While the research does indicate that breast implants make it more difficult to detect breast cancer at an early stage, the article also stated that other factors and confounders were not accounted for. This means that the results of the experiment should be taken with caution. If the breast implants are indeed a factor that make it more difficult to identify breast cancer at an early stage, I believe rather than discouraging women from getting breast implants, they should be aware of the risks of getting the implants. Personally, if I were a physician, I may be inclined to discourage my patient from getting the breast implants, but at the same time I can’t make such decision when I don’t know the priorities of my patient. The patient is already getting a mastectomy, and she may want implants for psychological, marital, etc reasons (this may also apply to a patient wanting implants for cosmetic reasons). Ensuring that the patient is aware of the risks, and allowing them to make an informed decision is more important in my opinion. However, if the breast implants are the direct cause of breast cancer a debate discussing its usage would certainly be valid. A procedure that directly causes a disease would be counter-productive. If a patient is receiving a mastectomy to prevent breast cancer in the first place, then receives breast implants that causes the disease, the mastectomy would be useless. It is a little more complicated for someone going in for merely cosmetic implants, because once again the priorities of the patient maybe different. Are they willing to get cosmetic implants at the risk of getting breast cancer? Once again, if I were a physician, I would not want my patient to get a procedure that directly causes breast cancer, but of course this would be a very complicated debate.

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  36. First, there needs to be more evidence between the correlation of breast implants and breast cancer. Ultimately, breast implants is a decision that women should make. Doctors should definitely communicate with their patients and alert them of the dangers behind breast implants if they have the genes for the cancer. It is a risk that the woman can take and no one can tell her that she cannot do it. It is a fundamental right that we make autonomous decisions and if the patient wants to risk it, then it is their choice. Physicians should not stop breast implants and be supportive/informative towards their patient's decision.

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  38. That number, a 26% increase of being diagnosed at a later stage than those without implants, is big. I've read accounts of physicians complaining about the decrease in sensitivity that a mammogram suffers from implants obscuring the view. I find it very hard to believe that the bulk of that 26% is due to confounding factors. Regardless of percentages, implants can indeed compromise a physician's ability to screen properly. This isn't funky, complicated science. The implant blocks your view.

    That other number, a 38% increased risk of death from breast cancer. That is massive. Let's say confounding factors account for half of that risk. That's still a 19% greater risk of dying. Not a greater risk of getting breast cancer, but dying from it. Who knows, maybe confounding factors account for all of that 38%. But how likely is that, really?

    No, people shouldn't be discouraged from implants. After having had a mastectomy, the patient has already made a tough sacrifice that dramatically decreases their risk of getting breast cancer. They deserve and are entitled to take back that sense of body image and alleviate the feeling that something is missing. But they must be informed of the outright fact that doing so will make detection of the very cancer that the sacrifice was supposed to avoid more difficult. By how much, we don't know for sure. But it does make detection more difficult. They also must be informed that the reduction of risk is likely much less when the implant is factored in. But even if there is a well established increase of risk from the implant, the procedure should not be made unavailable.

    If this data is legitimate, it should be very clear that some of the lost risk from the mastectomy is being given right back. Having a mastectomy and implants still effectively reduces risk, but the patient will have to worry much more than if they didn't have the implant.

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  39. In a situation similar to this one, the duty of the medical profession is to educate the patient of the available options and the potential consequences of those actions. They should refrain from pushing a particular course of action on a patient. The doctors should advise the woman on the risks of breast implants in a nondirective manner because ultimately they it is up to the woman to determine what she wants. Even the discovery of a definite correlation does not change this. However, the discovery of a correlation should encourage a serious discussion about the safety of breast implants. Debate is great!

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  40. If a woman is predisposed to cancer and she gets a mastectomy and then chooses to get breast implants I don't understand how she could still develop breast cancer if there is no breast tissue for it to manifest. Also, I think the article failed to say what the exact correlation between breast implants and breast cancer is. Do they think breast implants cause cancer because of the chemicals in it? Or because they make it harder to read a mammogram? If they cause cancer because of chemicals, then the woman should be educated on that and make a choice! If they cause cancer because they make it harder to read a mammogram then that won't affect her because she wouldn't have any breast tissue to have a mammogram on. Furthermore I think any woman who elects to have a mastectomy should have the option of breast implants because of all the image problems that come with having that procedure.

    Since the article is not very helpful in informing the community about the actual risk of breast implants and development of cancer I think that more medical professionals should be educated on how to read mammograms better in women with breast implants and if they have any doubt as to a shadow or something further research should be done. If there is a chemical problem with breast implants then they should be discouraged, for the general public until a better implant is designed. I don't think that women will ever stop getting breast implants in this day and age because of all the body image issues we have in American society.

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  41. One of the reasons why many women would feel okay if they decided to have a single or double mastectomy is that they have the option of getting cosmetic breast implants that would help them look and feel like a normal woman. Although that is not the only reason why women decide to get mastectomies, it plays a large factor in the appearance and physical nature of the woman body which can have a huge impact on their mental state. A mastectomy can decrease the chances of breast cancer from 85% to 5% for some women, thus decreasing the risk greatly and minimizing the chances to even less than a woman without a genetic predisposition to breast cancer. As a result, I firmly believe that a woman who decides to have a mastectomy, to be informed with the possible harms and dangers that accompany getting the surgery as well as do as much research as possible in order to make an informed decision. If the woman decides to go through with the surgery, fully informed, she can take preventative measures such as constant checkups as well as decided to have a breast reduction if necessary. If it is found that implants are a direct cause of breast cancer and this is based off of evidence-based research done in multiple studies, I would firmly suggest to patients that breast implant procedures is not the way to go as well as find another option instead of surgery. If they must have the surgery for reasons of their own, they must take extreme precautions and constantly have check ups, as common as twice a year. Although this is costly, this must be the standard that applies if breast cancer was directly correlated to breast augmentation procedures.

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  42. Mastectomies are a huge decision. Regardless of whether they are prophylactic or not, women struggle with the decision to remove a part of their body that helps to define their identity. You can't really say that about most of your other organs or body parts. Cutting away the breast tissue is more than just taking away skin; it is a psychological process as well as a medical one. I find it almost insulting that the article was posted in science daily let alone put up for discussion on this forum. The authors even state the evidence is circumstantial and there is a need for more research. Breast implants give many women who need these mastectomies a chance to own their bodies again. It can often feel like everything is being taken from you with diseases like breast cancer, and implants can be life changing for many women. The last thing I am interested in doing is policing women who want to get breast implants because of circumstantial evidence from before I was born.

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  43. I think that once a woman knows she is genetically predisposed to have a higher chance of getting breast cancer she has a choice to make. Many of them as stated may decide to get a single or double mastectomy. This would typically reduce their risk by a large percentage. Angelina Jolie for example stated how her risk went from 87% down to 5% after her mastectomy. I think that if the women can reduce their risk by that much a significance they can very well roll the dice with implants. Even though implants may impair an early detection, they have already chosen to drastically reduce their risk rather than roll the dice with an almost guaranteed breast cancer diagnosis. At that point, I do not see how implants can really be that much of a discussion.

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  44. Deciding whether or not to get a single or double mastectomy is an extremely difficult decision for most women however, with the advanced reconstructive surgeries that are available to women today, the decision has become a little easier. Having the ability to decrease your risk of breast cancer while maintaining your womanhood is a truly wonderful advancement. However, this article brings up a concern that breast implants pose a possible danger to women. I believe physicians must warn their patients of this risk associated with breast implants, but ultimately it is up to the patients to decide. I also believe there needs to be more research done on this topic because it is very important to the decision women face when they have an increased risk of breast cancer. If breast implants are found to in fact to be a direct cause of breast cancer, I do not believe the surgery it should be prohibited. Prohibiting the surgery would cause many women to reconsider getting a mastectomy, which is still putting them at risk of breast cancer, if not a higher risk. Women need to be able to make their own decisions about their health and prohibiting the surgery would restrict those rights.

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  45. As of now, women should not be discouraged from getting implants because as the article said, the results of this study should be interpreted with caution because they didn’t adjust for potential confounding factors. With that said, this article is alarming because if it is proven that implants have negative effects on being able to detect breast cancer, this would create a large dilemma for women to decide whether or not they should get a double mastectomy to decrease their risk of breast cancer. If implants are discouraged, this would eliminate the possibility of women to get a double mastectomy and still be able to have their appearance like before by getting implants put in. For many women, having implants allows them to still retain their feminine figure that they had pre-surgery, so I think it would be devastating for these women to learn that implants impose a greater risk of detecting breast cancer in the later stages after they already have to make the tough decision to get a double mastectomy. There should certainly my more research done on this topic before the proposed implications of the results are brought into practice to discourage women form getting implants.

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  46. I think this is a very hard topic to argue because many women feel that after having a mastectomy, they are no longer "sexy". To me, women should be able to do what they want to feel that they are beautiful (I know that women can go extreme with this concept but I am talking about when a women has had a procedure like a mastectomy prior). From what we learned about the BRCA1/2 genes, having the mastectomy greatly reduced the likelihood of having breast cancer. It put the women at a minuscule risk for developing breast cancer, down to one-digit percentages. I think that women should still be able to have implants put in if the same was true for this new gene. However, because research is still new, maybe doctors should persuade patients to hold off on the implants until there is more knowledge on such an issue.
    If breast implants were a direct cause of breast cancer, there should definitely be more of a debate on allowing women to get them. However, studies have shown that artificial tanning is a direct link to skin cancer and it is not illegal. I think there should just be more awareness given to the public and many will choose to opt out of such a procedure. There would definitely be a lot more caution by women who were thinking that implants were something that they wanted.
    When it comes down to it though, women are going to make the choices and decisions that they feel is right for them. The public can try to inform them about their risks but it is going to depend on the woman's choice.

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  47. As stated in the article, I definitely think that more research needs to be done and all possible confounding factors that blurred the results need to be controlled for. Getting a mastectomy/double mastectomy is a difficult decision for women, and breast implants is often a comfortable place to land on after the surgery. In our society, displaying your gender is a huge part of your identity and how the world sees you. I one day soon will be a health professional and I hope that I can help patients with similar health decisions in the future.

    But biology and medicine have to be balanced with comfort and happiness. If a patient feels the need to get breast implants in order to feel good about themselves, that's something that should obviously be discussed before jumping in. It would be helpful to have the statistics from further research, but if implants only slightly increase the risk of cancer not being caught early then many patients might not care. This whole "game" is a risky one; the mastectomy doesn't even guarantee anything. So I don't think I would advise against it. I would just make sure women in this situation undergo necessary preventative measures/check-ups regularly so that cancer can be caught. I feel like it'd be easy for someone to be happy with the results and live without a care; but I think at least a yearly checkup or a checkup twice a year would be necessary.

    It would change my mind, however, if implants were proven to increase risk of death from cancer, if the risk of breast cancer after mastectomy is significant.

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  48. For a woman testing positive with any gene that suggests they have a higher risk of developing breast cancer the choice to be proactive and get a mastectomy is a tough one. I would imagine that often times the thing that helps to push women towards getting a mastectomy is they have the option of making their bodies look less altered by being able to get breast implants. Although I certainly believe more research should be put into discovering exactly how much breast implants increase the risk of getting cancer, I don’t think that we should stop implant surgeries all together. Perhaps having the conversation to stop implants for women who did not have to get mastectomies is more appropriate with the amount of knowledge we currently have. Until more scientific proof has been obtained about implants causing later diagnosis of cancer I think that women who get mastectomies should continue to have access to implants.

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  49. Based on the conclusions of this study, I don’t think women who are currently deciding to undergo a double mastectomy should be discouraged from getting implants, if that is what they want. I think most women choose to have this reconstructive surgery to make up for the sense of femininity they feel is taken from them by having the surgery. As we saw in “In the Family”, many of the women who chose to have the surgery felt they had lost a large part of their identity at first. Then over time, they grew to appreciate the fact that because of the surgery, they were given a second chance at a better life than maybe they would have had otherwise. As the article addressed, the findings of this research are to be interpreted with caution, as the meta-analyses did not take into account any possible confounding variables. I believe that every woman deserves to feel beautiful, in whatever way they define that beauty. On the other hand, if further research is conducted, and it’s found that cosmetic breast implants are more detrimental than beneficial, I would discourage women from getting them. In my opinion, increasing one’s chance of living life is more important than cosmetic improvements; and if implants ruin that chance in the long run, it would be best to forgo them. However, I don’t think stopping breast implant procedures for women who have had double mastectomies altogether is the answer either. Doing so may or may not eliminate a problem that as of yet has little scientific backing, but it would also diminish these women’s choices, their hopes for better lives. In this or any other context, eliminating hope is never the answer.

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  50. I don't necessarily believe that women should be discouraged from getting implants, but they should definitely be educated about the risks. Informed consent is one of the overarching ideals of the medical profession, and doctors should stay true to this when informing women about breast implants.

    If it is found that breast implants directly cause breast cancer, then the debate becomes more difficult. It is similar to the well known fact that smoking cigarettes causes lung cancer; although it is clearly bad for your health, people still choose to do it. I don't believe that breast implants should be stopped, but rather the direct correlation to breast cancer and its risks should be publicized.

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  51. Since recent scientific evidence has shown that breast implants can make it more difficult to detect breast cancer, I feel that women who are genetically predisposed to breast cancer should be made aware of this risk and discouraged from having the procedure. While in the end, it is up to the woman, not the doctor, whether or not to go through with the procedure, she should still be informed of the risk and the doctor's feelings. If future scientific studies show that implants can be a direct cause of breast cancer, they should definitely be ended. I can't imagine why a woman would want to go through with a procedure that only has the potential to harm her health, not help it in the slightest.

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  52. As the article first and lastly suggests, more research needs to be done. In general, if breast implants make it hard to detect breast cancer, should women never get them? The answer is really up to each individual woman. In my opinion, if you already got a double or single mastectomy, do whatever you want because your risk of getting breast cancer has significantly dropped to a normal level. But another part of me thinks that if the risks are real, then maybe wait for a couple safe followups before breast implantation. If it comes to the point where breast implants is a direct cause of breast cancer, then at that point, I would highly suggest not getting them. Of course we do a lot of things that hurt ourselves in the long run, like eating Mcdonalds every meal or something, so if women want to get breast implants, then they should get them at their own informed risk.

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  53. I think that a physician is morally obligated to inform patients about their risks of developing conditions. They should inform the patients about the best medical route to take. For example, in this case, it would be wise to inform the patient that since she has a genetic predisposition to develop breast cancer, it could actually happen. Also, the implant has the possibility of creating shadows in mammograms, making it difficult to detect breast cancer at an early stage. Since the study is inconclusive, it is tough to say that there is a relationship between breast implantation and issues with early detectability. However, I think that patients should be discouraged from undergoing a breast implantation if their risk of developing the cancer is high. Ultimately, it is the patient’s decision whether or not to go through with the surgery, but I do feel that the risks should be clearly addressed and the decision should be talked over with the physician.

    If it is found implants are a direct cause of breast cancer, it would be appropriate to initiate that debate. However, I don’t think that we should just stop there. If implantation plays a role in developing breast cancer, it is unethical for it to be an accepted surgical procedure in hospitals. If we should be working to prevent the development of the disease, why would we make it lawful for the procedure to still be in effect? We would be signing away the health of many women for an unnecessary reason.

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  54. Women who are genetically predisposed to develop breast cancer should be aware that getting implants could make it more difficult to detect breast cancer. Of course, it is the woman’s decision, but they should be discouraged from having the procedure. Doctors can inform them of risks of the procedures, and maybe their thoughts on the procedure; however, it is ultimately the woman’s decision. The article did say that the information should be cautiously interpreted because they didn’t adjust for any confounding factors, which would change the outcome of the study. I think there should be more research on the topic that adjusts for confounding factors. This way we could get more accurate result before people start discouraging women.

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  55. Although the idea of having an increased risk of adverse breast cancer risks in women with breast implants may be possible, much research still need an to be done in order to determine the likelihood of the correlation. Many women who undergo single or double mastectomies often get breast implants as well in order to reconstuct their bodies after the surgery. If there is a possible risk of increased of adverse breast cancer risks, then doctors should make sure they communicate all possible risks to their patients so that they can make a well informed decision. In this case, since there is still little evidence, doctors should remind their patients on the value of the risk but, not discourage breast implants because there is no definitive evidence yet. However, if further research eventually shows that breast implants does lead to increased rate of deaths or adverse effects of breast cancer, then health care providers would need to start implementing controls and discourage breast implants that would put women at risk.

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  56. All humans should have freedom of choice. All humans should also have the right to information. Therefore, I believe that it is not in the health care providers’ place to discourage women from getting implants. However, this does not mean they they are not obligated to let women know about the risks of these breast implants. Health care providers should give women enough information so that they can make their own informed decisions regarding breast implants. This should be provided in an unbiased manner, hence the necessity of no discouragement.

    It is also important to note that these studies are only preliminary. There is no indication of a direct cause. There are many confounding factors, so rash decisions should not be made. However, in the event that implants are found to be a direct cause of breast cancer, there SHOULD be a debate regarding breast implant procedures. These discussions should aim to REDUCE breast implant procedures rather than to stop them; people should still have the right to receive such procedures if they wish to.

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  57. If there is a long family history of breast cancer, I believe we should advise women with stronger predisposition to breast cancer to not get implants until they have successfully detected whether or not they will develop cancer. However, like many have mention, getting implants is a choice that patients have, but doctors should also notify them on the increased risk of breast cancer due to implants, ESPECIALLY if the individual is aware of her family history in breast cancer. The medical community should never prohibit or discourage women on their choices, but we can inform and educate them about the risks and benefits. They should let the patients know that they have an option of getting breast implants after they have reduced their risk of breast cancer through mastectomies surgeries. Honestly, in this day and age with the advancements of surgery, I believe although some may view mastectomies as a surgery taking away 'womanhood,' there are alternatives available for women who are worried about not longer having breasts. However, because the article said they did not consider confounding factors, there needs to be more research done on the correlation between risk of breast cancer and implants. Ultimately, it is an individual's choice, but it should be the doctor's duty to fully inform the patient so they can make an informed choice which includes knowing about the risks of increased breast cancer with implants.

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  58. As the article stated, more research needs to be put into the association between the ability breast cancer detection and breast implants in order to determine what healthcare providers should tell their patients with regard to this issue. Right now, the authors have warned us that their findings (that those with breast implants having an increased risk of death from breast cancer compared to woman without implants) should be “interpreted with caution”. As a healthcare provider, I would not be inclined to seriously discourage my patients getting breast implants after getting a single or double mastectomy until more reliable literature and studies are produced on this matter. I would, however, present them with the fact that some recent studies show that getting implants COULD put them at higher risk of developing cancer, though there is not sufficient evidence to fully support these claims as of yet. If implants are found to directly cause breast cancer, a debate should certainly start about stopping breast cancer procedures for those who are at an increased genetic risk for developing breast cancer. However, some will likely argue that the patient has full discretion over decisions they make pertaining to health. Some may argue that stopping breast implant procedures for all those at higher risk for breast cancer could infringe on the patient’s right to autonomy, which is deeply wrong.

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  59. Vanessa Merta

    If a woman with the mutated gene decides to have a mastectomy, her chance of getting breast cancer decreases to about a 5% chance. If she were to not get breast implants after the mastectomy, she may have to deal with more emotional distress. I'm not sure that the 5% chance of developing cancer is worth that distress. Another reason why she should get the implants, if she wants them, is because her and her doctor would monitor her health intensely. If breast cancer were to develop, she would know probably quicker than the average woman, because of her predisposition. Obviously she should be warned of this risk, but she should not be deterred from having the procedure. If she gets mammograms and meets with her doctor regularly then I don't think having the implants is a problem.

    On the other hand, if this is a completely cosmetic surgery, the woman should be warned extensively. The increase that the researchers in Canada found is very high, and women should know about it before the procedure is done. In the end, having breast implants is a personal choice, and a woman should have control over her body. If she knows all of the risks and she still wants the procedure done then it is in her power to have it.

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  60. The research published to date suggests that cosmetic breast augmentation adversely affects the survival of women who are subsequently diagnosed as having breast cancer. Women have breast implants for all sorts of reasons and it's their body, their choice. The main concern is that these women make informed decisions and undergo the safest procedure possible.

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  61. I’m glad that the article points out its downfalls because I don’t believe it was very informative or stated anything that couldn’t be deduced from common sense. As for breast implants, I believe that any sort of procedure should be discussed between a patient and their physician. Women should know the risks of getting breast implants but should ultimately have the final decision. I also believe that women who decide to get breast implants should have a specific health plan they should follow in order to monitor their health. If it were found that implants were that cause, I believe a conversation should be started about stopping breast implants. However, I believe that stopping breast implants altogether may be a little paternalistic. That being said, it would seem necessary to start a debate in stopping breast implant procedures from a public health perspective.

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  62. I don't know that it's completely necessary to proceed as though breast implants undoubtedly cause cancer. I do however feel that is unwise for women carrying the gene in question to elect to have cosmetic surgery that could no doubt hinder the validity of any diagnostic testing they may undergo in the future. With that being established, if these women would like implants, it would be best if the implants proceeded a subcutaneous double mastectomy.

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  63. I think this article reflects in important finding. If Implants pose a risk , then I believe doctors should let their patients know about the future ramifications of getting an implant. However, I think it might be difficult to convince a women who just had a double mastectomy not to get breast implants because they want to return to their normal life as much as possible. As the article mentioned the findings should be interpreted with caution as some studies included in the meta-analysis on survival did not adjust for potential confounders. Therefore we have to be careful about our judgements but this definitely poses for more research.It is something that possibly may affect many women in the future especially as technology advances.

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  64. This article immediately brought me back to the film we watched in class. As we saw, to get a single or double mastectomy is a huge and difficult decision to come to terms with for a women. Though the research does indicate that breast implants increase the difficulty to detect breast cancer, the decision is 100% up to the women. The article also stated that other factors were not accounted for, this is saying that the results may not be fully accurate. There needs to be more evidence that demonstrates the correlation of breast cancer and breast implants. The choice to get breast implants is one that is completely up to the women. No matter what the genes of a women say, they should always be communicate greatly with the patient and fully inform them of all the risks behind getting the implants.

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  65. I believe that, even now, breast implants should be discouraged because it is suspected to cause breast cancer. They are not necessary and can be given when scientists have cleared that they do not in fact have a relation to breast cancer.

    If they are found to increase the risk of breast cancer, I believe that is should be highly recommended by doctors to not receive breast implants. I do not believe that it should be illegal because doctors, today, use Botox, which is a toxin to us if used in a large amount. If patients are told the risks of getting implants and are still choosing to receive them, I do not believe that they should be denied that right to have them.

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  66. I do believe that if women are predisposed to getting breast cancer should refrain from getting implants. I don't think if fair however, because these women will be forced to live without breasts if they have a mastectomy. This might affect their self esteem and confidence.However, I believe that they should keep their original breasts and screen for the cancer more carefully and that way the women can keep their breasts and be protected.

    No, I don't believe that they should stop implants. Instead, I believe that doctors should inform women that getting an implant will make it difficult to find the cancer and that it may cause breast cancer.

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  67. The information presented in this article seems somewhat inconclusive. I don’t think it should affect anyone’s decision to have breast implants until further research is conducted. That being said perhaps there needs to be additional screening for breast cancer in woman who have breast implants since mammograms cannot always detect cancer in these women. If more information comes to light about this study and proves a significant correlation between cosmetic breast implants and later diagnosis of breast cancer then this needs to be taken into consideration when women are considering this procedure.

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