Silicone breast implants have been widely used since the 1960s for both cosmetic and medical purposes. However, health concerns about their long-term effects continue to fuel debate, largely due to limited data and a lack of long-term registries. This makes it difficult to accurately estimate the number of women with implants or assess the true risks involved.
Recent imaging studies estimate that about 3% of women in the Netherlands and 4% in Italy have breast implants. As more women age with implants, their interactions with health systems—especially for heart disease—are drawing increased attention.
Heart disease remains the leading cause of death worldwide. For women, the disease often presents differently than in men, making diagnosis more difficult. Women are less likely to show typical symptoms like chest pain and more likely to have nonobstructive forms of coronary artery disease (CAD). This often requires more imaging and careful evaluation.
However, most cardiac diagnostic methods have been developed and validated primarily in men. This lack of gender-specific data makes accurate diagnosis in women even harder.
Diagnostic Challenges Linked to Implants
One growing concern is how breast implants might interfere with noninvasive heart tests such as echocardiography, SPECT (single-photon emission computed tomography), and PET (positron emission tomography). These imaging tools are commonly used to detect coronary ischemia and evaluate heart function.
Implants, whether silicone or saline, can cause artifacts in imaging. These artifacts can lead to false-positive results—where tests suggest heart disease even when arteries are not significantly blocked.
New Study Shows Impact
A recent study analyzed data from the National Inpatient Sample (NIS) database, focusing on women aged 18 and older who underwent coronary angiography—a test that examines blood flow in the heart’s arteries.
Of the 1.87 million women who received this test, 865,020 went on to receive percutaneous coronary interventions (PCI), such as stents. Among them, women with breast implants were, on average, 10 years younger than those without implants (55 vs. 65 years old).
Even after adjusting for other health factors—such as diabetes, high blood pressure, high cholesterol, and smoking—women with breast implants were more likely to receive abnormal results on heart function tests. The odds of a false positive were significantly higher (odds ratio 1.78; 95% confidence interval 1.22–2.68).
These women were also more likely to undergo coronary angiography (OR 1.3), but less likely to actually receive treatment like PCI (35.7% vs. 46.2%). This suggests that although tests often flagged potential heart issues, the follow-up procedures showed less need for intervention.
Implications for Women’s Health
These findings suggest that breast implants may interfere with the accuracy of cardiac testing, potentially leading to unnecessary procedures or delayed treatment decisions. Researchers emphasize the need for improved diagnostic strategies that account for the presence of implants and better address gender-specific differences in heart disease.
As the use of implants continues and the population ages, understanding their impact on diagnostic accuracy will be key to improving care for women.
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