"You have these implants; you get a second chance with a new set of breasts," said Susan, a Chicago native who got silicone implants in 2008 after a double mastectomy for breast cancer. "And now they're saying something may be wrong with them. What are we supposed to do?"
Susan is not alone. Since the U.S. Food and Drug Administration announced Wednesday that saline and silicone implants may be linked to anaplastic large cell lymphoma -- a rare but aggressive form of lymphoma -- plastic surgeons nationwide have been bombarded with calls and e-mails from worried patients.
"In some ways, I think this can be seen as positive when these reports come out, because it heightens awareness of all cancers, period. And that's a good thing," said Dr. David Song, vice chair of surgery and chief of plastic surgery at the University of Chicago, who has spoken to many of his patients about the report. "But patients should not panic. We're talking about a very, very rare form of cancer."
Although most women get breast implants for cosmetic reasons, about 57,000 women in the U.S. have had reconstructive breast implantation, according to the American Society of Plastic Surgeons.
"I think if you look at the positives of reconstructive breast implantation compared to the possible negative of this extremely rare cancer, the positives are overwhelmingly striking," Song said. "It can restore a sense of self, a sense of femininity, a sense of normalcy that many women feel breast cancer robbed them of."
Losing Breasts to Cancer
Susan was 37 years old and seven months pregnant when she noticed a lump in her right breast in 1992. After determining it was malignant, doctors delivered her baby by cesarean section a month early so she could start treatment.
"They didn't want do to the lumpectomy while I was still pregnant," said Susan, who now has a healthy 18-year-old son. "So they took him out, gave me a week at home, and then brought me back in to take out the lump."
A week later, she started daily radiation treatments for six weeks and then chemo for two months. As a single mother, she brought her newborn baby to her treatments, where the nurses and technicians would take turns looking after him.
The treatment was successful. But in 2004, Susan noticed another lump in her right breast. It was cancer again, but a different kind. Her doctors recommended removing her right breast, but Susan decided to have both breasts removed.
"Sometimes you don't realize what you have till it's gone," said Susan, who suffered from depression after the procedure.
"It was terrible," Susan said. "I had one child, was trying to take care of him. I wasn't married, I was single. I'm not a bad-looking person, but who am I going to present myself to with no breasts?"
In 2007, Susan met with Dr. Song to talk about reconstructive implants. And in 2008, she started the painful process of expanding the skin over her chest that would hold the C-cup implants Dr. Song put in place two months later.
"He just restored my life," Susan said.
Fear of Third Diagnosis
"My sister saw it too but didn't want to say anything because she thought it would upset me," Susan said. "I thought to myself: I survived breast cancer and now I'll die with implants."
But call to Dr. Song quickly put Susan's mind at ease.
"I'm basically stating the statistics: 34 to 60 patients in 10 million women with implants got this cancer," Song said. "I think right now it's in the forefront of people's minds because of the media coverage, but we need to make sure people understand the reality of the stats."
Song said the American Society of Plastic Surgeons is working closely with the FDA to investigate the link.
"It is such an exceptionally rare occurrence. But at the same time, it gives us pause to make sure we're doing the right thing for all our patients," Song said. "It's important to get the word out for all surgeons to be on the lookout for this. And I think patients should discuss this with their physicians, who should maintain the current vigilance for detecting cancer."
Susan says she no longer feels anxious about her implants, but she plans to follow up on the FDA's report during annual checkups with her oncologist, internist and Dr. Song.
"I will definitely mention it and say, 'What do I need to do?'" Susan said. "I know it's only rare cases, but I'll still ask what I should do and what I should be referred for to stay on top of it."