New FDA warning on silicone and saline breast implants: two new cancers (B-cell lymphoma and SCC)

Good morning, everyone. I want to discuss a very important topic, the topic of breast cancer. Breast cancer touches everybody's lives, men and women alike, because we all have wives, sisters, mothers, daughters, and it's a big problem in the Western Hemisphere especially. The reason I am discussing this right now is because of the new FDA warning. It has gone viral all over social media, on the news, and we want to address this at the Nadiri Center. Dr. Anderson, who is our breast and body specialist, is going to give you her analysis as well. But I wanted to start with some data. Data is solid data. Statistics, it's math. It's not opinion. It's not something that can be manipulated. This is from the CDC and the FDA directly, as well as published in the Lancet, which is one of the most prestigious journals in the world. Now, I'm going to go over some of this data with you. On September 8, 2022, the FDA warning came out reporting a new type of cancer called a squamous cell cancer, as well as B cell lymphomas. And we're going to talk about what's a B cell versus a T cell lymphoma. But these are new B cell lymphomas that were associated around the capsule, around the breast implant. Anytime there is a foreign body, whether it's a breast implant, whether it's a device that's placed under the skin, cardiac devices, orthopedic devices, even bullet wound, honestly, there are people that get shot and the bullet's not retrieved and it stays there. The body encapsulates it. It puts a capsule around it. So that's what the capsule is. And these new tumors were found within these capsules, and they're found within either saline or silicone, and they're found with either textured or smooth. And we're going to come back to this in a second. There were 10 squamous cell cancers and 12 lymphomas. And when the FDA went digging and did a literature review, they found less than 50 cases. Five zero cases total. Now, I want to put this in perspective. In 2018, one year, 2018 alone, in the United States, over 300,000 breast implants were done. So 50 cases ever were discovered of this type of tumor. And in the US in just one year, plastic surgeons did over 300,000 breast implants. So you can do the math. And it's a very, very, very small portion of the implants placed. Now, we're going to continue going because there was another tumor. This was a T cell tumor or a T cell Lymphoma called an anaplastic large cell lymphomas. And those were described a while back, and they were also found in the capsule around breast implants. Now, the FDA did not find it necessary to ban or remove textured implants. Those are around textured silicone implants. And. And again, the FDA's data did not support removing or banning it. But our surgeons at the Nidari center do not use it. We no longer use it. And we have videos. Dr. Anderson has made videos describing this issue. If you are somebody who received this type of an implant and you're concerned, certainly you can come in and have a consultation, discuss this with Dr. Anderson and our surgeons and discuss your level of concern. But the FDA did not find it necessary to remove or ban them. And in all, as of April 1, 2022, the FDA had received 1100 cases of this tumor. The T cell lymphoma, which is the previous tumor associated with textured silicone implants. The new one that has gone viral on social media is very different. Like I said, it's a B cell lymphoma or a squamous cell cancer, which is kind of like almost a skin cancer. And those were also previously described in places where there's chronic inflammation. And in fact, in all of those cases, the Epstein Barr virus was also discovered. And now there's belief that the Epstein Barr virus may be a mediator or contributor to those cases. Again, those cases, again, were less than 50. But the previous ones that were discussed, earned and discovered associated with the textured silicone implants, those were around 1100 cases total. Now, United Kingdom, we're going to discuss that as well, because we have data from the uk. In the uk, these T cell lymphomas, which were associated with textured silicone implants, there was 1 in 15,000 implants. Now, the UK doesn't do that many breast implants. They do about 7,000, 8,000 breast implants a year. That's it. The US far, far, far outnumbers that. I mean, we do 300,000, whereas they do 7 to 8,000. But even within those numbers, in the UK, they found 1 in 15,000 breast implants had that T cell lymphoma. And in fact, they have not discovered a single case of this new squamous cell cancer or the B cell lymphoma. Again, the data will change because some of these things are underreported and it takes time. Slowly will come in. But again, if you compare it and look at all the different numbers, they're very, very, very small compared to the number of implants that are done. Now, unfortunately, in the uk, one in seven women will get breast cancer. They not related to breast implants. And in the us, one in eight women will get breast cancer not related to breast implants. So it is a huge, huge, huge problem. It affects and destroys lives. We need to find a solution for it. But breast implants being blamed for it is a little bit of an emotional reflex reaction not supported by statistics. Now I'm going to give you more statistics. In the US, 2019 CDC data, 1.8 million new cancers, total cancers, every type of cancer was described. 1.8 million. Close to 600,000 people died of cancer in 2019. 2022 data, 300,000 new cases of breast cancer this year, 2022, 300,000 new cases of Breast Cancer in the US and 50,000 precancerous ductile in situ cancers. And unfortunately, tragically, 40,000 women will lose the battle and lose their lives to breast cancer. Again, not related to breast implants, but breast cancer. Now, this is eye opening, going to tell you the top 10 causes of cancer worldwide and in the US, top 10 causes, number one. And it's not in any particular order, but I'm going to list them. Tobacco, tobacco find in cigarettes, vaping, anything. And unfortunately, it's still very common. It's, it's a choice and there's no doubt that it causes cancer. Radon found in certain homes and basements. Asbestos, which obviously is no longer used, but it's still around in some older buildings. Now, here is something that's going to blow your mind. Crispy brown foods, fried foods. How many of you eat fried chicken? How many of you eat french fries? How many of you fry things, make it nice and yummy and crispy and brown. It is a carcinogen. Formaldehyde. Again, the average person's not around formaldehyde, but UV rays from the sun, A lot of people around UV rays from the sun. And it's out there, everybody's out there sun tanning, everybody's out there sunbathing. And it kills and it kills and it kills year after year. And it's avoidable. Now here's another one that again, nobody's talking about but alcohol. Six percent of all cancers in the US were associated with alcohol, even one a week. It's not about alcoholics, it's not about people that are consuming 40 beers a day or a week or whatever. Even one drink, one cocktail, is now known to be a carcinogenic processed meats. Hot dogs, cold cuts. Clearly a carcinogen. Clearly carcinogen. So the point of this entire lecture, call it, is that there are so many things out there that we're exposed to, whether it's tobacco, alcohol, fried foods, processed foods, sunlight. And nobody's running in panic and hysteria, posting and reposting on social media. But These less than 50 cases of cancers around breast implant capsules has gone viral. I just want to put her in perspective. It's just a perspective. Again, even one case is too many. I wish not a single single case was out there. Even one is too many. But again, we have to put her in perspective. And if you are concerned, if you are worried, please come sit down. Talk to our surgeons. Talk to Dr. Anderson. Discuss your concern. Implants can be removed. Capsules can be removed. If you're planning on getting it and you're worried about it, think about it. Do your research. Nobody forces anybody to get cosmetic surgery. Everything has risks. From anesthesia to infection to bleeding, there's plenty of risks. And this new type of cancer is another risk. You have to think about implant rupture. There's a lot of things you have to think about. But when you do the statistical analysis and you look at the number of cases done per year and how it's made people feel more confident, given them a boost of just vibrant energy, they feel more confident, whether in clothes, in a bikini, at home, around their significant others. Whatever it is, the improvements in people's lives that have come about from breast implants versus the risks, you have to have that internal debate and discussion for yourself. But I feel perfectly comfortable. My wife recently had her breast augmentation by our amazing Dr. Anderson. Many of our staff have had it, many of our doctors have had it. We are not scared of it. But the data has been analyzed, we are cognizant of it. And it's a risk reward calculation. And every person has to do that calculation for themselves and see if it's worth the risk or not. But the risk is extremely, extremely, extremely low.

In the news, there's been some new recent concern about safety and breast implants. The new report was 16 new cases of squamous cell cancer associated with breast implants. Specifically, it's the capsule of the implant that seems to have this tumor growth. It's not involving the implant itself, but rather the tissue that forms around the implant. This is still an exceedingly rare cancer and not truly breast cancer in origin. What I would guide patients is that if you currently have implants in your normal surveillance is really all you need to do if you're considering implants, because this is still so exceedingly rare. It was should. It should not dissuade you necessarily. But it's just another component of risks associated with any implantable device, specifically breast implants. I want to briefly review with you surveillance of breast implants. So if you've chosen to have breast implant surgery and you have implants in place, our recommendations would be an annual exam with your physician to do just a visual as well as a examination of the implant themselves. Approximately five to six years after they've been placed. We recommend some sort of imaging modality. So that would. Classically, it's been an MRI to check for the integrity of the implant. More recently, there's been interest in using ultrasound, and that seems to be equally effective as monitoring. So five to six years after the implants are placed, you do your first surveillance, and then every two to three years thereafter, same modality, you go ahead and have an imaging performed to determine the integrity of the implant. If anytime during those breaks in radiologic evaluation, you notice a change in shape, size, or feeling of the implant, we'd recommend that you see your physician sooner in order to check for changes to the implant or any of the associated problems related to those implants. Risks associated with breast implants is a sobering topic. Ultimately, scientific evidence supports their safety. The vast majority of women who choose to have breast implants are very happy with that choice. Ultimately, I have no reservation or hesitation in utilizing implants for myself or for any friends or family.