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Aesthet Surg J. 2019 Jun 26. pii: sjz136. doi: 10.1093/asj/sjz136. [Epub ahead of print]

Breast Implant Prevalence in the Dutch Female Population Assessed by Chest Radiographs.

Author information

1
Department of Plastic, Reconstructive, and Hand Surgery of Maastricht University Medical Center, Maastricht, Netherlands.
2
Dutch BIA-ALCL Consortium.
3
Department of Plastic, Reconstructive, and Hand Surgery of the Medical Spectrum Twente, Enschede, Netherlands.
4
Division of Epidemiology of the Netherlands Cancer Institute, Amsterdam, Netherlands.
5
Department of Radiology Medical Spectrum Twente, Enschede, Netherlands.
6
Division of Pathology, VU University Medical Center.
7
Dutch Nationwide Network and Registry of Histo- and Cytopathology, Houten, Netherlands.
8
Department of Radiology, Maastricht University Medical Center, Maastricht, Netherlands.

Abstract

BACKGROUND:

Breast implant-related health problems are a subject of fierce debate. Reliable population-based estimates of implant prevalence rates are not available, however, due to a lack of historical registries and incomplete sales data, precluding absolute risk assessments.

OBJECTIVES:

This study aimed to describe the methodology of a novel procedure to determine Dutch breast implant prevalence based on the evaluation of routine chest radiographs.

METHODS:

The validity of the new method was first examined in a separate study. Eight reviewers examined a series of 180 chest radiographs with (n = 60) or without (n = 120) a breast implant confirmed by a computed tomography or magnetic resonance imaging scan. After a consensus meeting with best-performing expert reviewers, we reviewed 3000 chest radiographs of women aged 20 to 70 years in 2 large regional hospitals in the Netherlands in 2015. To calculate the national breast implant prevalence, regional prevalence variations were corrected utilizing the National Breast Cancer Screening Program.

RESULTS:

Eight reviewers scored with a median sensitivity of 71.7% (range, 41.7%-85.0%) and a median specificity of 94.6% (range, 73.4%-97.5%). After a consensus meeting and a reevaluation by best-performing expert reviewers, sensitivity was 79.9% and specificity was 99.2%. The estimated national prevalence of breast implants among women between 20 and 70 years was 3.0%, ranging from 1.7% at 21 to 30 years to 3.9% between 51 and 60 years.

CONCLUSIONS:

The novel method in this study was validated with a high sensitivity and specificity, resulting in accurate prevalence estimates and providing the opportunity to conduct absolute risk assessment studies on the health consequences of breast implants.

LEVEL OF EVIDENCE: 2:

PMID:
31242279
DOI:
10.1093/asj/sjz136

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