Brustimplantatassoziierte Tumoren

Zusammenfassung

Zusätzlich zu dem anaplastischen großzelligen T-Zell-Lymphom (BIA-ALCL) werden seit einigen Jahren weitere Tumoren im Zusammenhang mit Implantaten beschrieben. Sehr selten traten Plattenepithelkarzinome (SSC) und B-Zell-Lymphome auf. Die ungeklärte Pathogenese sowie das unklare individuelle Risikoprofil bringen eine anhaltende Verunsicherung von Patienten und Ärzten mit sich. Während das BIA-ALCL gehäuft im Zusammenhang mit texturierten Brustimplantaten auftritt, wurden die anderen Tumoren auch bei glattwandiger Textur und anderen Implantatlokalisationen beobachtet. Multiple potenzielle Mechanismen werden diskutiert. Eine vermutlich multifaktorielle Genese, die zu einer chronischen Entzündungsreaktion mit konsekutiver Immunstimulation führt, scheint eine Schlüsselrolle bei der malignen Transformation zu spielen. Für eine spezifische Risikobewertung liegen bisher keine ausreichend validen Daten vor, weshalb diese zurückhaltend erfolgen muss. Dargestellt werden Inzidenz, Pathogenese und Evidenzlevel des aktuellen Wissensstands sowie eine Bewertung und Diskussion der aktuellen Literatur.

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.

Schlüsselwörter

Brustimplantat - Lymphom - BIA-SCC - Immunstimulation - texturierte Implantate - Plattenepithelkarzinom - implantatassoziierte Tumoren - BIA-ALCL

Keywords

breast implant - lymphoma - BIA-SCC - immunostimulation - textured implants - squamous cell carcinoma - implant-associated tumors - BIA-ALCL

Publication History

Article published online:
22 March 2024

• References/Literatur

• 1 ASPS. PROFILE Registry and FDA BIA-ALCL Data Comparison. Accessed May 17, 2023 at: https://www.plasticsurgery.org/documents/Health-Policy/ALCL/PROFILE-Data-Summaries.pdf
• 2 Groth AK, Clemens MW, Graf R. et al. Breast Implant-Associated Anaplastic Large-Cell Lymphoma in Brazil: What Are We Missing?. Plast Reconstr Surg 2022; 150: 970e-978e DOI: 10.1097/prs.0000000000009652.
• 3 Spronk PER, Begum H, Vishwanath S. et al. Toward International Harmonization of Breast Implant Registries: International Collaboration of Breast Registry Activities Global Common Data Set. Plast Reconstr Surg 2020; 146: 255-267 DOI: 10.1097/PRS.0000000000006969.
• 4 Prantl L, von Fritschen U, Liebau J. et al. Concept for a National Implant Registry to Improve Patient Safety. Handchir Mikrochir Plast Chir 2016; 48: 320-329 DOI: 10.1055/s-0042-118863.
• 5 de Boer M, van Leeuwen FE, Hauptmann M. et al. Breast Implants and the Risk of Anaplastic Large-Cell Lymphoma in the Breast. JAMA Oncol 2018; 4: 335-341 DOI: 10.1001/jamaoncol.2017.4510.
• 6 Fleury EF C. Silicone Induced Granuloma of Breast Implant Capsule (SIGBIC) diagnosis: Breast Magnetic Resonance (BMR) sensitivity to detect silicone bleeding. PLoS One 2020; 15: e0235050 DOI: 10.1371/journal.pone.0235050.
• 7 Ramos-Gallardo G, Carballo-Zarate AA, Cuenca-Pardo J. et al. What is the Evidence of Lymphoma in Patients with Prostheses Other Than Breast Implants?. Aesthetic Plast Surg 2020; 44: 286-294 DOI: 10.1007/s00266-019-01569-1.
• 8 von Fritschen U, Solbach C, Prantl L. Wie sicher sind Silikonimplantate?. Senologie 2019; 16: 92-93 DOI: 10.1055/a-0897-0043.
• 9 Blombery P, Thompson ER, Prince HM. Molecular Drivers of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Plast Reconstr Surg 2019; 143: 59S-64S DOI: 10.1097/PRS.0000000000005570.
• 10 Stuttgen K, Croessmann S, Fetting J. et al. Pathogenic Germline Variants in Patients With Metastatic Breast Cancer. JAMA Oncol 2019; 5: 1506-1508 DOI: 10.1001/jamaoncol.2019.3116.
• 11 Swerdlow SH, Campo E, Pileri SA. et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016; 127: 2375-2390 DOI: 10.1182/blood-2016-01-643569.
• 12 ISAPS. International Survey on Aesthetic/Cosmetic Proceures. Accessed March 02, 2023 at: https://www.isaps.org/media/vdpdanke/isaps-global-survey_2021.pdf
• 13 FDA. Medical Device Reports of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Accessed February 02, 2023 at: https://www.fda.gov/medical-devices/breast-implants/medical-device-reports-breast-implant-associated-anaplastic-large-cell-lymphoma
• 14 Government of Canada. Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) – Canadian Surveillance 2021 Data. Accessed February 02, 2023 at: https://health-infobase.canada.ca/datalab/bia-alcl-blog.html
• 15 European Commission Scientific Committee on Health, Environmental and Emerging Risks (SCHEER). Final Opinion on the safety of breast implants in relation to anaplastic large cell lymphoma. Accessed February 02, 2023 at: https://health.ec.europa.eu/system/files/2022–08/scheer_o_018.pdf
• 16 BfArM. Möglicher Zusammenhang zwischen Brustimplantaten und der Entstehung eines anaplastischen großzelligen Lymphoms (ALCL). Accessed February 02, 2023 at: https://www.bfarm.de/SharedDocs/Risikoinformationen/Medizinprodukte/DE/Brustimplantate_ALCL_FDA.html;jsessionid=E76572DA3D2363EFCB0DCD330F94E0A3.intranet662?nn=939498
• 17 Doren EL, Miranda RN, Selber JC. et al. U.S. Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Plast Reconstr Surg 2017; 139: 1042-1050 DOI: 10.1097/prs.0000000000003282.
• 18 Loch-Wilkinson A, Beath KJ, Magnusson MR. et al. Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia: A Longitudinal Study of Implant and Other Related Risk Factors. Aesthet Surg J 2020; 40: 838-846 DOI: 10.1093/asj/sjz333.
• 19 Cordeiro PG, Ghione P, Ni A. et al. Risk of breast implant associated anaplastic large cell lymphoma (BIA-ALCL) in a cohort of 3546 women prospectively followed long term after reconstruction with textured breast implants. J Plast Reconstr Aesthet Surg 2020; 73: 841-846 DOI: 10.1016/j.bjps.2019.11.064.
• 20 Wang Y, Zhang Q, Tan Y. et al. Current Progress in Breast Implant-Associated Anaplastic Large Cell Lymphoma. Front Oncol 2021; 11: 785887 DOI: 10.3389/fonc.2021.785887.
• 21 Magnusson M, Beath K, Cooter R. et al. The Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand Confirms the Highest Risk for Grade 4 Surface Breast Implants. Plast Reconstr Surg 2019; 143: 1285-1292 DOI: 10.1097/PRS.0000000000005500. (PMID: 30789476)
• 22 de Boer M, Hauptmann M, Hijmering NJ. et al. Increased prevalence of BRCA1/2 mutations in women with macrotextured breast implants and anaplastic large cell lymphoma of the breast. Blood 2020; 136: 1368-1372 DOI: 10.1182/blood.2019004498.
• 23 DeCoster RC, Clemens MW, Di Napoli A. et al. Cellular and Molecular Mechanisms of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Plast Reconstr Surg 2021; 147: 30e-41e DOI: 10.1097/prs.0000000000007423.
• 24 Fleming D, Stone J, Tansley P. Spontaneous Regression and Resolution of Breast Implant-Associated Anaplastic Large Cell Lymphoma: Implications for Research, Diagnosis and Clinical Management. Aesthetic Plast Surg 2020; 44: 1109-1115 DOI: 10.1007/s00266-020-01810-2. (PMID: 29872907)
• 25 Loch-Wilkinson A, Beath KJ, Knight RJW. et al. Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand: High-Surface-Area Textured Implants Are Associated with Increased Risk. Plast Reconstr Surg 2017; 140: 645-654 DOI: 10.1097/PRS.0000000000003654.
• 26 Hu H, Johani K, Almatroudi A. et al. Bacterial Biofilm Infection Detected in Breast Implant-Associated Anaplastic Large-Cell Lymphoma. Plast Reconstr Surg 2016; 137: 1659-1669 DOI: 10.1097/PRS.0000000000002010.
• 27 Walker JN, Hanson BM, Pinkner CL. et al. Insights into the Microbiome of Breast Implants and Periprosthetic Tissue in Breast Implant-Associated Anaplastic Large Cell Lymphoma. Sci Rep 2019; 9: 10393 DOI: 10.1038/s41598-019-46535-8.
• 28 Munhoz AM, Clemens MW, Nahabedian MY. Breast Implant Surfaces and Their Impact on Current Practices: Where We Are Now and Where Are We Going?. Plast Reconstr Surg Glob Open 2019; 7: e2466 DOI: 10.1097/GOX.0000000000002466.
• 29 Malcolm TI, Hodson DJ, Macintyre EA. et al. Challenging perspectives on the cellular origins of lymphoma. Open Biol 2016; 6: 160232 DOI: 10.1098/rsob.160232.
• 30 Jones P, Mempin M, Hu H. et al. The Functional Influence of Breast Implant Outer Shell Morphology on Bacterial Attachment and Growth. Plast Reconstr Surg 2018; 142: 837-849 DOI: 10.1097/PRS.0000000000004801.
• 31 Adlard J, Burton C, Turton P. Increasing Evidence for the Association of Breast Implant-Associated Anaplastic Large Cell Lymphoma and Li Fraumeni Syndrome. Case Rep Genet 2019; 2019: 5647940 DOI: 10.1155/2019/5647940.
• 32 Laurent C, Nicolae A, Laurent C. et al. Gene alterations in epigenetic modifiers and JAK-STAT signaling are frequent in breast implant-associated ALCL. Blood 2020; 135: 360-370 DOI: 10.1182/blood.2019001904.
• 33 Oishi N, Hundal T, Phillips JL. et al. Molecular profiling reveals a hypoxia signature in breast implant-associated anaplastic large cell lymphoma. Haematologica 2021; 106: 1714-1724 DOI: 10.3324/haematol.2019.245860.
• 34 Clemens MW, Jacobsen ED, Horwitz SM. 2019 NCCN Consensus Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Aesthet Surg J 2019; 39: S3-S13 DOI: 10.1093/asj/sjy331.
• 35 Adrada BE, Miranda RN, Rauch GM. et al. Breast implant-associated anaplastic large cell lymphoma: sensitivity, specificity, and findings of imaging studies in 44 patients. Breast Cancer Res Treat 2014; 147: 1-14 DOI: 10.1007/s10549-014-3034-3.
• 36 Clemens MW, Horwitz SM. NCCN Consensus Guidelines for the Diagnosis and Management of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Aesthet Surg J 2017; 37: 285-289 DOI: 10.1093/asj/sjw259.
• 37 Clemens MW, DeCoster RC, Fairchild B. et al. Finding Consensus After Two Decades of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Semin Plast Surg 2019; 33: 270-278 DOI: 10.1055/s-0039-1696998.
• 38 Fricke A, Wagner JA, Kricheldorff J. et al. Microbial detection in seroma fluid preceding the diagnosis of breast implant-associated anaplastic large cell lymphoma: a case report and review of the literature. Case Reports Plast Surg Hand Surg 2019; 6: 116-120 DOI: 10.1080/23320885.2019.1593846.
• 39 DePaola NEK, Coggins H. Breast Implant-Associated Anaplastic Large Cell Lymphoma: What We Know. J Adv Pract Oncol 2019; 10: 54-61
• 40 Quesada AE, Medeiros LJ, Clemens MW. et al. Breast implant-associated anaplastic large cell lymphoma: a review. Mod Pathol 2019; 32: 166-188 DOI: 10.1038/s41379-018-0134-3.
• 41 Lyapichev KA, Piña-Oviedo S, Medeiros LJ. et al. A proposal for pathologic processing of breast implant capsules in patients with suspected breast implant anaplastic large cell lymphoma. Mod Pathol 2020; 33: 367-379 DOI: 10.1038/s41379-019-0337-2.
• 42 Magnusson MR, Deva AK. Letter to Editor: Fleming D, Stone J, Tansley P. Spontaneous Regression and Resolution of Breast Implant-Associated Anaplastic Large Cell Lymphoma: Implications for Research, Diagnosis and Clinical Management, APS 2018. Aesthetic Plast Surg 2018; 42: 1164-1166 DOI: 10.1007/s00266-018-1141-y.
• 43 Schiller JT, Lowy DR. An Introduction to Virus Infections and Human Cancer. Recent Results Cancer Res 2021; 217: 1-11 DOI: 10.1007/978-3-030-57362-1_1. (PMID: 33200359)
• 44 Khoo C, McTigue C, Hunter-Smith DJ. et al. EBV positive fibrin/chronic inflammation associated diffuse large B-cell lymphoma: an incidental finding associated with a breast implant. Pathology 2021; 53: 673-675 DOI: 10.1016/j.pathol.2020.09.022.
• 45 Malata CM, Madada-Nyakauru RN, Follows G. et al. Epstein-Barr Virus-associated Diffuse Large B-cell Lymphoma Identified in a Breast Implant Capsule: A New Breast Implant-Associated Lymphoma?. Ann Plast Surg 2021; 86: 383-386 DOI: 10.1097/SAP.0000000000002537.
• 46 Medeiros LJ, Marques-Piubelli ML, Sangiorgio VFI. et al. Epstein-Barr-virus-positive large B-cell lymphoma associated with breast implants: an analysis of eight patients suggesting a possible pathogenetic relationship. Mod Pathol 2021; 34: 2154-2167 DOI: 10.1038/s41379-021-00863-1.
• 47 Morgan S, Tremblay-LeMay R, Lipa JE. et al. Breast implant-associated EBV-positive diffuse large B-cell lymphoma: Two case reports and literature review. Pathol Res Pract 2021; 226: 153589 DOI: 10.1016/j.prp.2021.153589. (PMID: 34455365)
• 48 Mansy M, Wotherspoon AC, El-Sharkawi D. et al. Fibrin-associated diffuse large B-cell lymphoma misdiagnosed as breast implant-associated anaplastic large-cell lymphoma. Histopathology 2021; 79: 269-271 DOI: 10.1111/his.14372.
• 49 Chen VW, Hoang D, Clancy S. Breast Implant-Associated Bilateral B-Cell Lymphoma. Aesthet Surg J 2020; 40: NP52-NP58 DOI: 10.1093/asj/sjy093.
• 50 Smith BK, Gray SS. Large B-cell lymphoma occurring in a breast implant capsule. Plast Reconstr Surg 2014; 134: 670e-671e DOI: 10.1097/PRS.0000000000000535.
• 51 FDA. Breast Implants: Reports of Squamous Cell Carcinoma and Various Lymphomas in Capsule Around Implants. Accessed February 02, 2023 at: https://www.fda.gov/medical-devices/safety-communications/breast-implants-reports-squamous-cell-carcinoma-and-various-lymphomas-capsule-around-implants-fda
• 52 Copie-Bergman C, Niedobitek G, Mangham DC. et al. Epstein-Barr virus in B-cell lymphomas associated with chronic suppurative inflammation. J Pathol 1997; 183: 287-292 DOI: 10.1002/(SICI)1096-9896(199711)183:3<287::AID-PATH932>3.0.CO;2-Q.
• 53 Ryan C, Ged Y, Quinn F. et al. Classical Hodgkin Lymphoma Arising Adjacent to a Breast Implant. Int J Surg Pathol 2016; 24: 448-455 DOI: 10.1177/1066896916632587.
• 54 Har-Shai L, Har-Shai Y, Metanes I. et al. Composite breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and extra-nodal marginal zone lymphoma (MZL) in the capsule of a silicone breast implant. Autoimmun Rev 2019; 18: 556-557 DOI: 10.1016/j.autrev.2019.03.014.
• 55 Bacon CM, O’Donoghue JM. Commentary on: Breast Implant-Associated Bilateral B-Cell Lymphoma. Aesthet Surg J 2020; 40: NP59-NP62 DOI: 10.1093/asj/sjz304.
• 56 Vorstenbosch J, Chu JJ, Ariyan CE. et al. Clinical Implications and Management of Non-BIA-ALCL Breast Implant Capsular Pathology. Plast Reconstr Surg 2023; 151: 20e-30e DOI: 10.1097/PRS.0000000000009780.
• 57 Kitchen SB, Paletta CE, Shehadi SI. et al. Epithelialization of the lining of a breast implant capsule. Possible origins of squamous cell carcinoma associated with a breast implant capsule. Cancer 1994; 73: 1449-1452 DOI: 10.1002/1097-0142(19940301)73:5<1449::aid-cncr2820730520>3.0.co;2-j.
• 58 Soni SE, Laun JC, Beard AS. et al. Breast Implant Capsule-Associated Squamous Cell Carcinoma during Pregnancy: A Mimicker of Breast Implant-Associated Anaplastic Large-Cell Lymphoma. Plast Reconstr Surg 2022; 150: 926e-928e DOI: 10.1097/PRS.0000000000009506.
• 59 Buchanan PJ, Chopra VK, Walker KL. et al. Primary Squamous Cell Carcinoma Arising From a Breast Implant Capsule: A Case Report and Review of the Literature. Aesthet Surg J 2018; DOI: 10.1093/asj/sjy092.
• 60 Zomerlei TA, Samarghandi A, Terando AM. Primary Squamous Cell Carcinoma Arising from a Breast Implant Capsule. Plast Reconstr Surg Glob Open 2015; 3: e586 DOI: 10.1097/GOX.0000000000000567.
• 61 Olsen DL, Keeney GL, Chen B. et al. Breast implant capsule-associated squamous cell carcinoma: a report of 2 cases. Hum Pathol 2017; 67: 94-100 DOI: 10.1016/j.humpath.2017.07.011.
• 62 Smith LF, Smith TT, Yeary E. et al. Squamous cell carcinoma of the breast following silicone injection of the breasts. J Okla State Med Assoc 1999; 92: 126-130
• 63 Goldberg MT, Llaneras J, Willson TD. et al. Squamous Cell Carcinoma Arising in Breast Implant Capsules. Ann Plast Surg 2021; 86: 268-272 DOI: 10.1097/SAP.0000000000002524.
• 64 Zhou YM, Chaudhry HE, Shah A. et al. Breast Squamous Cell Carcinoma Following Breast Augmentation. Cureus 2018; 10: e3405 DOI: 10.7759/cureus.3405.
• 65 Paletta C, Paletta FX jr., Paletta FX sr.. Squamous cell carcinoma following breast augmentation. Ann Plast Surg 1992; 29: 425-429 DOI: 10.1097/00000637-199211000-00009.
• 66 Whaley RD, Aldrees R, Dougherty RE. et al. Breast Implant Capsule-Associated Squamous Cell Carcinoma: Report of 2 Patients. Int J Surg Pathol 2022; 30: 900-907 DOI: 10.1177/10668969221086940.