"We knew that the textured prostheses were not evaluated"

The International Consortium of Investigative Journalists (CIJI) is releasing Novel Revelations on Texturized Breast Prostheses on November 27th. These granular surface implants, designed to better adhere to the tissues, are indeed suspected of being at the origin of rare forms of lymphoma. A few days before the publication of the survey, the French Medicines Agency (ANSM) sent a message of caution to surgeons, asking them to stop using these implants. But this shy warning comes too late, since the first suspicions date back 10 years ago. Several doctors have already given the alert, without ever being heard. Among them, Professor Maurice Mimoun, who heads the reconstructive and reconstructive plastic surgery department at the Saint-Louis Hospital in Paris. On November 27, he came to speak on the set of Health Magazine.

• To date, in France, 56 cases of anaplastic large cell lymphoma have been reported in women with bad implants. Could these cancers have been avoided?

Professor Maurice Mimoun: It's hard to know, but we could have avoided textured prosthetics. It's been 20 years since I say that it should not be put, and I'm very angry, because out of 500,000 women in France who have bad prostheses, 85% probably have textured prostheses. They are very anxious!

Twenty years ago, we did not know that this could lead to anaplastic cancers, but we knew that the texture was not evaluated. She was supposed to train fewer hulls [des durcissements, ndlr]. In reality, it is not so: it has even been proven that sometimes, this texture leads to more!

There is a kind of novelty attraction. But the new prosthesis or device is not necessarily good. It must be evaluated! At one point, we could not even pay for the non-textured prostheses, even though there was nothing to justify it.

There is a kind of internet-driven rush: patients ask, doctors read things, but there is no evaluation.

• There is an inertia of the health authorities on the subject …

We see if the products are toxic, etc., but we do not evaluate the interest of the product. What right can we give to a woman or a man a prosthesis or other device if it has not been evaluated for several years? By what right do we not warn the patient? We can not tell him "madam, it's been a year"because we do not know what will happen in 10 years! For texture, we did not know, and she gave some anaplastic cancers.

• It is said, however, that microtextured prostheses may be interesting.

Professor Maurice Mimoun: This is a second trompe-l'oeil. Do not put texture at all. We will reduce the texture until the prostheses are smooth, in the end!

Microtextures in some brands that are macrotextures in others, so we do not understand anything! We tell the patient "you know, with the new, more modern texture, you're going to have fewer shells". We do not know anything !

• You had banned the installation of textured prostheses in your department, and you had alerted on the subject.

Professor Maurice Mimoun: I have power in my service, so I have banned them. But after, what do you want me to do? When I banned them, there was still no suspicion of cancer. I just knew that no evaluation had been done. Of course, you have to try to find new things, but beware of the evaluation! When a laboratory comes to see me and offers me a prosthesis when three years ago, he has already offered me one, I ask "but why, the old was not good? What am I going to say to the women to whom I asked it?"It's a bidding war, you have to be wary of medico-commercial information, it's all but medical information.

• Do women know exactly what they have been asked for as a type of prosthesis?

Professor Maurice Mimoun: A priori yes. But do not panic. After, everything is in evaluation, so I do not know what to say. The number of cancers is very low, and they are often treated. But telling women to take it off is a risk. I do not yet have a completely clear opinion on the subject.