Breast implants, rare cancers linked

Dear Dr. Roach: I recently caught a quick news headline on breast cancer stating that there are now findings of cancer in women who have had breast implants. What can you tell us about these new findings and studies?

V.G.

Answer: In 2019, the U.S. Food and Drug Administration (FDA) identified a rare cancer, anaplastic large cell lymphoma, as being associated with a particular type of textured breast implants — the vast majority made by one company, Allergan, who was requested to (and subsequently did) recall all textured breast implants.

In September 2022, the FDA noted 10 cases of squamous cell carcinoma in people with breast implants, but also noted that there is not “enough information to say whether breast implants cause these cancers or if some implants pose higher risk than others.” They continued, “The FDA does not recommend the removal of breast implants because of this safety communication.” The communication also noted different types of lymphomas (not the same as those identified in 2019) associated with both textured and smooth implants.

Squamous cell cancer and these lymphomas are rare cancers whose incidence are not welldescribed, so it is not clear if implants increase the risk of developing this cancer (or, if they do, by how much). For the anaplastic large cell lymphoma, an analysis of six published studies showed a risk of about 1 in 10,000 people over a lifetime of a breast implant. Even though this risk is small, it should still be considered by anyone considering a breast implant. I would not recommend removing a breast implant just because of these reports. It is not clear that the benefits of removing implants are worth that small risk.

Dear Dr. Roach: Any suggestions for over-thecounter supplements to reduce glucose? My sugar level is 116 mg/dL. My doctor has not recommended medication.

H.P.B.

Answer: I have read about several supplements that are recommended for people with diabetes. These include chromium, berberine and cinnamon, among others. There have been some small trials that appear to show benefits, but larger trials have not shown a great deal of success.

Diabetes is best prevented by a combination of good eating habits and regular exercise. Critical advice includes avoiding sweets and having a good balance of whole grains, nuts and other protein sources, while avoiding processed grains, like white rice or pasta, and breads made with processed flour. Any kind of exercise helps, but 20 minutes a day of moderate to intense exercise is a good goal for many people.

Interpreting a single sugar level can be tricky. If that level was after fasting, that level is diagnostic of the prediabetes level, but it may well be normal two hours after eating. A glucose tolerance test remains the definitive way to diagnose diabetes, but diabetes is most commonly diagnosed (and monitored) by the hemoglobin A1c level now, with normal being below 5.7%; prediabetes is 5.7% to 6.4%; and diabetes is 6.5% or greater. There are some medical conditions where these numbers have to be adjusted. If your doctor isn’t recommending medication, I’d recommend strongly to find out what you can do with your eating habits and exercise so you can save money on supplements.