The presidents of two leading plastic surgery organizations urged members to downplay the significance of recent evidence about the risks of breast implant-related cancer when speaking to female patients, according to the transcript of portions of a Feb. 3 members-only Webinar sent to Public Citizen by a concerned plastic surgeon.
Don’t use the word “cancer” -- instead use “condition,” one of the presidents is said to have advised.
Public Citizen has sent a letter to the Food and Drug Administration (FDA) to alert it to the practice and to call for it to be stopped.
Language battle
The FDA announced Jan. 26, a week before the Webinar, that there has been a growing number of published cases documenting an unusual kind of cancer surrounding the breast in women with implants. The American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) held the Webinar partly in response to the announcement.
When recommending how to respond to patients who were concerned about the growing number of cases of anaplastic large cell lymphoma (ALCL), Dr. Phil Haeck, ASPS president, said, “Yes, it’s classically a malignant tumor, but it has such a benign course that when we were discussing ways to talk to the media, we decided that we would call this a condition when we talked to the media -- not a tumor, not a disease and certainly not a malignancy … and I would recommend that you use the same terms with your patients rather than disturb them by saying this is a cancer, this is a malignancy.”
ASPS responds
A spokesman for the American Society of Plastic Surgeons says the publication of a partial transcript of a conference call where Dr. Phil Haeck was quoted speaking to physicians about how to describe the ALCL condition has been taken out of context and misconstrued.
"Far from intending to trivialize or minimize the issue," ASPS told ConsumerAffairs.com, "Dr. Haeck’s extemporaneous remarks were well understood by the physicians present to mean that the type of ALCL that has been observed in possible association with breast implants does not appear to have the malignant course of classic ALCL which is a systemic disease."
ASPS says its position is and has always been that ALCL associated with breast implants is a serious, but an extremely rare condition. "The specific nature of this condition is unclear," the spokesman said, "and it is important that more research be conducted; however, it is clear that the condition is not breast cancer, and this was confirmed by the FDA in its announcement."
A cure?
The Webinar also stated, “surgery [to treat the cancer] was curative,” which contradicts evidence, said Dr. Sidney Wolfe, director of Public Citizen’s Health Research Group. “The ASPS and the ASAPS have chosen to ignore the currently available facts from published case reports of breast implant-associated ALCL.”
Public Citizen’s analysis of the 34 reported cases of ALCL found that:
- In half of the cases (17), the reported treatment included chemotherapy, a combination of chemotherapy and radiation therapy, or radiation therapy;
- In three of these cases, the cancer came back after the initial treatment; and
- Two additional patients (not included in the 17 mentioned above) saw their cancer come back after initial unspecified therapy, underwent stem cell transplantation and were disease-free two years after transplantation.
“These plastic surgery organizations claim that surgery cured women with ALCL, yet nearly 15 percent saw their cancer recur,” Wolfe said. “For most patients, chemotherapy and/or radiation therapy will be part of the recommended treatment plan. And for the organizations to refer to this cancer as ‘benign’ or as a ‘condition’ misleads both patients who may have received breast implant or those who may be considering undergoing breast implant surgery and the physicians who may provide care to such patients.”
Public Citizen is calling on FDA to stop "this misleading effort to keep women in the dark about the dangers of breast implants so they will continue to ask for them."
