Breast Implant-Associated Tumors

Abstract

In addition to anaplastic large T-cell lymphomas (BIA-ALCL), other implant-related tumors have been described for some years. Squamous cell carcinoma (SSC) and B-cell lymphomas occurred in very rare cases. The unexplained pathogenesis as well as the unclear individual risk profile is an ongoing source of uncertainty for patients and physicians. The pathogenesis of the tumors is still largely not understood. While BIA-ALCL occurs more frequently with textured breast implants, other tumors were also observed with smooth implants and at other implant sites. Multiple potential mechanisms are discussed. It is suspected that the etiology of a chronic inflammatory response and subsequently immunostimulation is multifactorial and appears to play a key role in the malignant transformation. Since there are currently no sufficiently valid data for a specific risk assessment, this must be done with caution. This article presents the incidence, pathogenesis, as well as the level of evidence according to the current state of knowledge, and evaluates and discusses the current literature.

BIA-ALCL and BIA-SCC: Updates on Clinical Features and Genetic Mutations for Latest Recommendations

“…The first question that arises is how a squamous cell carcinoma can differentiate from a non-epithelial tissue such as that of the periprosthetic capsule, which is predominantly populated by fibroblastic cells and immune system cells. Chronic inflammation as a cause of metaplasia and subsequent epithelial cell cancerization is among the hypothesis advanced [7]. If it is assumed that squamous cell carcinoma first arises from a benign squamous epithelium, the origin of the epithelial cells should be uncovered.…”

“…Current evidence suggests that breast implants-of different types and textures-may favor alterations on nearby tissues and cells recruited at the implant capsule, which, in the long-term and under given stimuli, might cause tumorigenesis [7]. Despite the investigation conducted in the field so far, the actual risk and driving factors for the development of breast implant-associated tumors are yet to be clarified.…”