Breast Implant Prevalence in the Dutch Female Population Assessed by Chest Radiographs. (26th June 2019)

• Record Type: Journal Article
• Authors: de Boer, Mintsje; van Middelkoop, Michele; Hauptmann, Michael; van der Bijl, Noortje; Bosmans, Jorn A W; Hendriks-Brouwer, Narda; Schop, Sijmen J; de Boer, Jan Paul; Hijmering, Nathalie J; Overbeek, Lucy I H; Lobbes, Marc B I; Klazen, Caroline A H; de Jong, Daphne; Rakhorst, Hinne A; van der Hulst, René R W J; van Leeuwen, Flora E
• Is Part Of: Aesthetic surgery journal. Volume 40:Number 2(2020)
• Page Start: 156
• Page End: 164
• Publication Date: 2019-06-26
• Subjects: Surgery, Plastic -- Periodicals; 617.95
• DOI: 10.1093/asj/sjz136
• Languages: English
• ISSNs: 1090-820X

Abstract

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: