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

Abstract

Currently, attention has been given to complications related to breast implants, especially due to the presence of anaplastic large cell lymphoma (ALCL) related to silicone implants. Many manuscripts attempt to associate silicone presence with clinical complaints reported by patients, while others try to demonstrate the mechanisms of silicone bleeding by permeability loss of breast implant surfaces. There also are reports of foreign body type reactions from implant fibrous capsule to silicone corpuscles. However, there seems to be no study that correlates the clinical, radiological, and histological correlations of these lesions. The objective of this review is to correlate radiological findings of silicone-induced granuloma of breast implant capsule (SIGBIC) from breast MRI (BMRI) scans and complementary findings of ultrasound (US) and positron emission tomography (PET) scan, and its histology originated from surgical breast implant capsulectomy. To make this correlation possible, we divided SIGBIC into three radiological findings: (1) intracapsular SIGBIC, (2) SIGBIC with extracapsular extension, and (3) mixed SIGBIC associated with seroma. Our experience demonstrates histological-radiological correlation in SIGBIC diagnosis. Knowledge of these findings may demonstrate its real importance in terms of public health and patient management. We believe that SIGBIC is currently underdiagnosed by lack of training, guidance, and management in our clinical practice.

Silicone Induced Granuloma of Breast Implant Capsule (SIGBIC) diagnosis: Breast Magnetic Resonance (BMR) sensitivity to detect silicone bleeding

“…We recently described the radiological findings of a granuloma developed in the intracapsular compartment of breast implants that was formed by an immune response of the fibrous capsule to the free silicone particles bleeding from intact breast implants [16]. After a certain time or when subjected to stress situations (like heat and trauma), all breast implants may alter the surface permeability and may present gel bleeding of the internal contents or leakage of the shell [1].…”

“…SIIS clinical manifestations may vary and depend on the intensity of the inflammatory reaction of the host. [16].…”

“…We have described 3 BMRI features that are irrevocable for this diagnosis: 1. black-drop signal; 2. mass with hyper signal at T2-weighted sequences; and 3. late contrast enhancement [15]. Besides, we described the physiopathology of the disease [16]. (Fig 1).…”

Not All That Shines on a PET Scan Is Cancer: A Silicone-Induced Granuloma Masquerading as Malignancy

“…There is still much speculation around the pathophysiology of silicon-induced granuloma of breast implant (SIGBIC). It occurs in approximately 27% of individuals who have a silicone breast implant [ 9 ]. These silicone particles are believed to cause an autoimmune response increasing T-cell activation.…”

Implantate der weiblichen Brust – Teil 2: Implantatkomplikationen

“…Dieses Phänomen wird auch als SIGBIC (Silicone-induced granuloma of the breast implant capsule) [26,27] bezeichnet.…”