After the pelvic mesh scandal, women now face a new risk due to surgical mesh used in breast reconstruction
Campaigners are demanding an urgent investigation into the safety of surgical mesh used in thousands of NHS breast cancer operations every year.
They fear the material, used in breast reconstruction, leaves women with life-changing injuries and chronic pain and dependent on a daily diet of painkillers to cope.
There are fears the mesh could harm some patients, just as vaginal mesh, used for years by the NHS to tackle incontinence, left thousands of people in pain, disability and suicidality.
A woman told The Mail on Sunday that mesh was stitched into her abdomen after cancer surgery left her feeling like someone was ‘twisting a knife in my stomach’. Another blamed the mesh in her rebuilt breast for an infection that caused her silicone implant to collapse and slide under her armpit. She is now awaiting corrective surgery on the NHS.
The mesh, made from animal tissue or synthetic material, is implanted into the reconstructed breast to help support the new structure, or into the abdomen to replace the muscle and tissue grafted from there to form a new breast .
An estimated 170,000 women were damaged by vaginal mesh
The alarm has been raised by campaign group Sling The Mesh, which highlighted the dangers of vaginal mesh – despite the problem being initially denied by medics. In 2018, a damning report by Baroness Julia Cumberlege led to the immediate suspension of NHS vaginal mesh operations after a review heard a catalog of stories from women damaged by the operation.
In some, the mesh cut through the flesh until it protruded through the vagina. In other cases it broke off and traveled to other vital organs. In the Cumberlege review we heard how some women needed wheelchairs and were unable to work.
An estimated 170,000 women were damaged by vaginal mesh. Kath Sansom, a former journalist who founded Sling The Mesh after suffering health problems from a vaginal implant, said the group has received an increasing number of complaints from women who had similar problems with breast blades.
“It’s like 2015 when I was desperately trying to get people to listen to me about vaginal mesh,” she warned.
‘Many will probably not even realize that mesh has been implanted, and if they report problems, they will be told that doctors have never seen complications in other women and that they should aspirate it, just like with vaginal mesh.’
Around 57,000 women in Britain are diagnosed with breast cancer every year. About 15,000 undergo a mastectomy, in which the entire breast is removed. About 3,000 per year undergo immediate breast reconstruction, while another approximately 1,500 undergo it at a later stage.
Surgeons use different techniques to shape a new breast.
An increasingly popular method is to use a mesh that acts as an ‘internal bra’ to hold the new breast tissue – a silicone implant or fatty tissue from the abdomen or buttocks – in place.
Another procedure involves taking muscle and fat from the abdomen to firm up new breast tissue, then implanting mesh in the stomach area to strengthen it.
A recent study by doctors at Frimley Health NHS Foundation Trust in Surrey, which looked at 93 patients who had breast implants fitted, found that just under a third suffered complications in the year after surgery, including implant failure and infections.
And in 2021, the U.S. Food and Drug Administration warned that there was a greater risk of complications with implants made from animal tissue. This is usually taken from pigs or cows and stripped of all cells, creating a scaffold-like structure to hold new breast tissue in place.
The FDA warned that some brands of animal implants are linked to an increased risk of infection. A clinical trial is underway at the University of Oxford to compare the safety and effectiveness of mesh versus no mesh in cancer patients.
Liz O’Riordan, retired breast surgeon and co-author of The Complete Guide To Breast Cancer, said complications were common with early mesh implants used to strengthen the abdomen after tissue harvesting. But that operation is less common on the NHS because it can be traumatic for patients.
However, using mesh to rebuild breasts is generally much safer, she said. ‘Sometimes patients do get a contracture (where scar tissue around the mesh squeezes the implant, causing pain and a deformed breast), but you don’t get the kind of long-term complications from this technique that we see with vaginal mesh. ‘
Jemma Parker, 40, from St Albans in Hertfordshire, says she used mesh to rebuild her breasts after requiring regular doses of the powerful painkiller tramadol following a double mastectomy a decade ago.
The mother-of-three, who runs her own beauty salon, had her breasts removed at the age of 30 because she carries the BRCA1 gene, which puts her at a very high risk of cancer.
“My mother and my aunt were both diagnosed with breast cancer in their 30s, and I didn’t want my children to see me go through the same thing,” says Jemma. But she is convinced that the pig tissue implant used causes the silicone implant to collapse and move towards her armpit.
‘Now it’s pressing on a nerve and causing numbness in my arm. I am in line for surgery to correct it,” she says.
Studies show that this can happen when the immune system reacts to the mesh, causing the tissue to swell and pushing the implant out of place.
‘It’s like a knife turning inwards’
Jane Stoddart, 53, had a double mastectomy in 2011 and two years later had a reconstruction using fat and muscle from her abdomen
Jane Stoddart, 53, has been in pain for the past 11 years, she says, due to the effect of mesh used during her breast cancer operation.
The mother of three underwent a double mastectomy in 2011 and two years later had a reconstruction using fat and muscle from her abdomen.
“Within a few days I knew there was a problem,” she told The Mail on Sunday.
‘The pain was unbearable, as if I was being stabbed and the knife was being twisted into me. That was in April 2013 and I have been in constant pain ever since.’
Jane, from Birmingham, says she didn’t know surgeons had used mesh until she needed a hysterectomy due to suspected uterine cancer six months after her reconstruction.
‘The operation should have taken a few hours, but it took almost all day.
‘The surgeon later said my intestines were a mess because of the gauze. I had no idea it was even there.
‘I was in too much pain and worried about my recovery to make a complaint. But when I brought it up to the doctors later, I was told it was all in my head.’