Silicone-induced granuloma of breast implant capsule (SIGBIC): similarities and differences with anaplastic large cell lymphoma (ALCL) and their differential diagnosis

Abstract

Primary breast lymphoma is a rare disease and accounts for 0.5% of cases of breast cancer. Most primary breast lymphomas develop from B cells, and the involvement of T cells is rare. Anaplastic large cell lymphoma (ALCL) is a recently discovered T-cell lymphoma associated with breast implants. Only a few cases have been reported to date. It is believed that the incidence of ALCL is increasing because of the increasing number of breast implants. The clinical presentation is variable and can manifest as a palpable mass in the breast or armpit, breast pain, or capsular contracture. Because of the rarity of the disease and the lack of knowledge to date, clinical diagnosis is often delayed, with consequent delays in treatment. The cause and pathogenesis have not been fully elucidated, and there are no evidence-based guidelines for diagnosis, treatment, or follow-up of this disease. We present a review of cases of patients with silicone breast implants, including ALCL, a rare type of breast cancer that is still under study, and silicone-induced granuloma of breast implant capsule and its differential diagnosis, and discuss if a silicone-induced granuloma of breast implant capsule could be the precursor of the disease.

Silicone-Induced Granuloma of Breast Implant Capsule (SIGBIC): Histopathology and Radiological Correlation

“…Additional symptoms are skin rash, arthralgia, pruritus, and asthenia. These findings are similar to those described by de Faria Castro Fleury et al where SIIS cases were compared over a 30-year period [ 9 ].…”

Papillary endothelial hyperplasia (Masson's tumor) developed in the capsule of the implant in a breast cancer patient treated with mastectomy and radiation therapy

“…Silicone‐induced breast implant capsule granulomas are masses in the virtual space between the breast implant and the fibrous capsule . They are induced by the “bleeding” of silicone through an intact implant envelope causing a granuloma.…”

“…Silicone-induced breast implant capsule granulomas are masses in the virtual space between the breast implant and the fibrous capsule. 13 They are induced by the "bleeding" of silicone through an intact implant envelope causing a granuloma. MRI findings are an intra-capsular heterogeneous mass with smooth margins, black drop sign consisting of tiny round hypo-intense foci appearing between the lesion and the capsule and late contrast enhancement, usually with a progressive type 1 curve pattern.…”

Application of Breast Ultrasound Elastography to Differentiate Intracapsular Collection from Silicone-Induced Granuloma of Breast Implant Capsule Complementarily to Contrast-Enhanced Breast Magnetic Resonance Imaging

“…Studies still need to be performed to determine whether there is relationship between SIGBIC and ALCL. 1 We hypothesized that ALCL is an evolution of SIGBIC, an autoimmune disorder. This should be confirmed in future studies.…”

“…It results from the formation of granuloma, induced by silicone bleeding from the inside of the intact breast implant into the space between the implant and its fibrous capsule. 1 …”