In the most recent episode of the SHE MD podcast, SZA candidly explained why she had her breast implants removed. The 34-year-old “Snooze” singer shared that her mother was diagnosed with breast cancer years ago, and that her aunt had a mastectomy. Her doctor told her this family history significantly spiked her risk of developing the disease, which influenced her decision to reverse the procedure.
SZA also said that, when she first got the implants, she learned that she had “so much” fibrosis, a thickening of connective tissue that can develop in the breasts, which her doctor removed during the surgery. She said she eventually had the implants removed because she “didn’t feel good, and it was painful,” explaining, “I got way too much scar tissue because my breasts are too dense and I’m not supposed to have breast implants. And I ended up getting extra fibrosis.”
But what is fibrosis, exactly, and how does it relate to implants? And how does breast cancer risk play into all of this? We asked experts to break it down.
First, some background: Fibrosis isn’t limited to just the boobs.
You can develop this thickened or scarred tissue in lots of areas: It’s essentially the same stuff that your ligaments (the tissues that hold your bones together) and scars are made of, so areas that have it might feel firm or even a bit rubbery, according to the American Cancer Society (ACS).
Fibrosis can develop as you heal after an injury, which includes major surgery, or from your immune system reacting to a foreign body, like a breast implant. In fact, in most people with breast implants, the body’s protective cells react by forming a “fibrotic capsule” around the implants. In some folks, the immune system responds strongly, and if the capsule gets thick enough, it can become pretty painful.
“The body tries to either get rid of it or wall it off for its own protection,” Richard J. Bleicher, MD, a breast cancer specialist in the department of surgical oncology at Fox Chase Cancer Center in Philadelphia, tells us. “The process of doing this involves inflammation, which is an increase in the activity of the immune system.”
SZA didn’t share a specific diagnosis, but the pain that she talked about could have alluded to a capsular contracture, which happens when the capsule tightens and becomes really hard, Amy Bremner, MD, the medical director of breast surgical oncology at MemorialCare Saddleback Medical Center in Laguna Hills, California, tells us. “That can be painful and it can lead to patients wanting their implants removed or revised,” she explains.
Dr. Bleicher says most people aren’t usually evaluated for fibrosis before getting breast implants because this tissue can be tough to spot without specialised (read: expensive) imaging tests. Plus, it’s super common: More than half of people with breasts will develop fibrosis, usually between the ages of 30 and 50. “It is routine for surgeons to encounter this,” Dr. Bleicher says. “Even during the placement of implants, it can usually be [removed] easily by the surgeon at the time of the procedure.”
Is fibrosis related to breast cancer? What about implants?
At baseline, having fibrosis doesn’t increase your risk of developing breast cancer, per the ACS. The simplest way to put it: Fibrosis is a sign that there’s inflammation happening in the body — but it’s chronic inflammation, not the fibrosis itself, that could potentially contribute to an environment that has been associated with cancer risk, Dr. Bleicher says.
SZA also mentioned that she has dense breasts (which refers to having more of certain kinds of tissue in your boobs than others), and this is also associated with a much greater risk of breast cancer, in part because this tissue can make it harder to spot concerning changes on a mammogram.
A family history of breast cancer isn’t usually enough of a reason not to get implants if you’re interested in them — but it does mean you’ll probably need more intensive breast cancer screening later on, Amy Bremner, MD, the medical director of breast surgical oncology at MemorialCare Saddleback Medical Center in Laguna Hills, California, tells us. “There is some concern that cancers can’t be detected as easily with implants, which is why we recommend doing mammograms as well as breast MRI.”
Breast implants have also been directly linked to some forms of cancer, including breast implant-associated anaplastic large cell lymphoma (BIA-ALCL, a cancer of the immune system) and, in extremely rare cases, squamous cell carcinoma that forms in the capsule.
If your boobs — or body — feel bad after implants, talk to your doctor.
Breast implant illness is a constellation of symptoms that can affect people with any type of implant, and it’s recently gained a lot more attention. The condition can lead to chronic fatigue, joint and muscle pain, rashes and other skin issues, brain fog, memory problems, and headaches, among a whole slew of other symptoms.
SZA said that her breast implants “ended up hurting me” — but after getting them removed, she’s much feeling better: “I took them out, and now, they’re just my boobs.”
This article originally appeared on SELF.
