Women with breast cancer who have reconstructive surgery after a mastectomy are much less likely to have complications if they have a polyurethane-coated implant, according to research.
About 55,000 women are diagnosed with breast cancer in the UK every year, of whom about 30% have a mastectomy. Many of these will subsequently have radiotherapy.
Many women opt to have reconstructive surgery. But hard, painful scar tissue can form around the implant, especially if they have had radiotherapy.
Research shows that radiotherapy after mastectomy and breast reconstruction is associated with a higher risk of complications and additional surgery. But until now there has been limited real-world evidence about whether the type of implant can influence the risk of scarring.
A new study has shown that polyurethane-coated implants reduce scarring and the need for further surgery. The implants are made of silicone, but have a spongy outer layer made of polyurethane.
European scientists studied about 1,500 women in 15 countries who were treated for breast cancer between 2016 and 2024 and had a mastectomy, followed by reconstruction with a breast implant and subsequently radiotherapy. A third of the women received a polyurethane-coated implant, while just under 1,000 did not.
The study then tracked the women’s health for two-and-a-half to three years. Preliminary findings, presented at the European Breast Cancer Conference in Barcelona, showed that those who had a polyurethane-coated implant were significantly less likely to develop hardened scar tissue, called capsular contracture.
One-third of women (32.8%) who had a polyurethane-coated implant developed capsular contracture, compared with nearly half (47.5%) of patients who received standard implants. They were also less likely to need secondary surgery to remove the scar tissue or to have a major infection in the breast.
Dr Kerstin Wimmer, a surgeon at the Medical University of Vienna, said: “Our study suggests that women who received polyurethane-coated implants had far fewer problems after radiotherapy than those who received standard implants.”
The results suggest that the type of implant used “may have a major impact on the risk of complications after radiotherapy”, and provide important evidence to guide reconstructive planning for patients who are likely to need radiotherapy, she added.
Prof Isabel Rubio, Head of Breast Surgical Oncology at the Clínica Universidad de Navarra in Madrid, said the findings could help improve patient comfort, aesthetic outcomes and overall quality of life.
“As we continue to move towards more personalised breast cancer care, evidence like this is valuable in guiding implant selection and treatment planning,” she said. “The ultimate goal is not only to treat the cancer effectively, but also to minimise long-term side effects and enhance recovery for patients.”
Catherine Priestley, senior clinical nurse specialist at Breast Cancer Now, said comparing how compatible different implants are with radiotherapy in terms of the risk of complications is “extremely important”.
“It can help women make more informed and personalised choices, helping them to live better following breast cancer treatment,” she said.
“We know how emotionally and physically difficult it is for women to go through further procedures when they are already adjusting to breast cancer treatment or to changes to their body after surgery.”
Sarah Downey, president of the Association of Breast Surgery, said: “Breast implants continue to be an important option for many patients undergoing reconstruction, which can help to restore confidence and offer the potential for an improved quality of life. We look forward to further research in this area.”
