Case analysis of breast implant-associated squamous cell carcinoma
10.3760/cma.j.cn114453-20230511-00103
- VernacularTitle:乳房假体相关鳞状细胞癌病例分析
- Author:
Shangshan LI
1
;
Jie LUAN
;
Chunjun LIU
Author Information
1. 中国医学科学院北京协和医学院整形外科医院乳腺综合整形科，北京 100144
- Keywords:
Breast;
Breast implants;
Squamous cell carcinoma;
Case analysis
- From:
Chinese Journal of Plastic Surgery
2023;39(9):984-989
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the reported cases of breast implant-associated squamous cell carcinoma (BIA-SCC) and to explore the diagnosis and treatment of BIA-SCC.Methods:BIA-SCC related literature published in PubMed database and Wanfang Medical database until March 2023 were searched. The country and year of publication, gender and age of patients, duration from initial implant placement to presentation, implant type, clinical manifestations, whether the tumor invaded extracapsular tissue, treatment, histopathological findings and follow-up result were analyzed.Results:Twelve BIA-SCC articles (15 cases in total) were included, including 11 cases from the United States, 2 cases from China, 1 case from Australia and 1 case from Japan. One case was published in 1992 and 14 cases from 2015 to 2023. There were 1 male and 14 female patients. Patient age of onset was (55.3±9.6) years. The time from implant insertion to onset of BIA-SCC was (24.5±9.4) years. Implant types include smooth implants, textured implants, silicone gel implants, saline implants, and liquid silicone gel. All 15 patients had breast pain and swelling. Four cases presented erythema, thin or broken skin; and capsular contracture was found in 7 cases. Three tumors were confined to the capsule, 10 invaded the outer capsule (most of them had distant metastases), and 2 were unspecified. During the treatment, breast implants were removed and capsulectomy was performed, followed by radiotherapy (7 cases) or chemotherapy (8 cases). Post-operative histopathologic findings suggested squamous cell carcinoma, or a transition from atypical squamous metaplasia to increased cell atypia and abnormal immature keratinization. After the operation, 9 cases were followed up for 3 months to more than 8 years, of which 5 cases did not have obvious recurrence, and 4 cases had multiple metastasis, died or received palliative end-of-life treatment.Conclusion:BIA-SCC should be excluded if breast swelling and pain occur many years after breast prosthesis implantation, and adequate systemic evaluation should be conducted to check whether there is distant metastasis. The diagnosis was confirmed by histopathological examination of the tumor, timely removal of implants, extensive resection of the tumor, and systematic treatment combined with other auxiliary methods.
