The Breast Tumor Microenvironment: Could Silicone Breast Implant Elicit Breast Carcinoma?

Eduardo Fleury,1 Cristiane Nimir,2 Gabriel Salum D’Alessandro3 1Service of Radiology, IBCC – Instituto Brasileiro de Controle do Câncer, São Paulo, SP, Brazil; 2Service of Pathology, FEMME – Laboratório da Mulher, São Paulo, SP...

Full description

Bibliographic Details
Main Authors: Fleury E, Nimir C, D'Alessandro GS
Format: Article
Language:English
Published: Dove Medical Press 2021-01-01
Series:Breast Cancer: Targets and Therapy
Subjects:
Online Access:https://www.dovepress.com/the-breast-tumor-microenvironment-could-silicone-breast-implant-elicit-peer-reviewed-article-BCTT
_version_ 1818431142632620032
author Fleury E
Nimir C
D'Alessandro GS
author_facet Fleury E
Nimir C
D'Alessandro GS
author_sort Fleury E
collection DOAJ
description Eduardo Fleury,1 Cristiane Nimir,2 Gabriel Salum D’Alessandro3 1Service of Radiology, IBCC – Instituto Brasileiro de Controle do Câncer, São Paulo, SP, Brazil; 2Service of Pathology, FEMME – Laboratório da Mulher, São Paulo, SP, Brazil; 3Service of Plastic Surgery, IBCC – Instituto Brasileiro de Controle do Câncer, São Paulo, SP, BrazilCorrespondence: Eduardo FleuryService of Radiology, IBCC – Instituto Brasileiro de Controle do Câncer, Rua Maestro Chiaffarelli, 409, São Paulo, SP ZIP 01432-030, BrazilEmail edufleury@hotmail.comAbstract: Complications related to breast implants have received much attention recently. Breast implant-associated anaplastic large cell lymphoma, silicone-induced granuloma of breast implant capsule, and breast implant illness are the main complications reported in the medical literature. However, the literature contains limited evidence regarding the possibility of silicone implants eliciting breast carcinoma. In this manuscript, we propose a theory in which the immune response to silicone breast implant gel bleeding acts as a triggering point for tumor oncogenesis in breast tissue. This hypothesis is derived from our findings of a case of invasive and undifferentiated medullary carcinoma in a patient with a silicone breast implant. The following concepts have been used to support this theory: 1) silicone bleeding from intact breast implants; 2) metaplasia: an adaptation to injury and precursor to dysplasia and cancer; 3) T-cell dysfunction in cancer immunity; 4) inhibitory cells in the tumor microenvironment (TME); 5) morphogenesis and bauplan; and 6) concepts underlying medullary carcinoma. We propose that the inflammatory process in response to silicone particles in the pericapsular glandular tissue favors the development of cellular mutations in specialized epithelial cells. This reverse morphogenesis could have resulted in breast carcinoma of the medullary type in the present case.Keywords: breast implant-associated anaplastic large cell lymphoma, BIA-ALCL, breast implant illness, BII, silicone granuloma, breast cancer, breast implant
first_indexed 2024-12-14T15:44:36Z
format Article
id doaj.art-9838d395600643bb9e8801cd4be30ae7
institution Directory Open Access Journal
issn 1179-1314
language English
last_indexed 2024-12-14T15:44:36Z
publishDate 2021-01-01
publisher Dove Medical Press
record_format Article
series Breast Cancer: Targets and Therapy
spelling doaj.art-9838d395600643bb9e8801cd4be30ae72022-12-21T22:55:32ZengDove Medical PressBreast Cancer: Targets and Therapy1179-13142021-01-01Volume 13455861259The Breast Tumor Microenvironment: Could Silicone Breast Implant Elicit Breast Carcinoma?Fleury ENimir CD'Alessandro GSEduardo Fleury,1 Cristiane Nimir,2 Gabriel Salum D’Alessandro3 1Service of Radiology, IBCC – Instituto Brasileiro de Controle do Câncer, São Paulo, SP, Brazil; 2Service of Pathology, FEMME – Laboratório da Mulher, São Paulo, SP, Brazil; 3Service of Plastic Surgery, IBCC – Instituto Brasileiro de Controle do Câncer, São Paulo, SP, BrazilCorrespondence: Eduardo FleuryService of Radiology, IBCC – Instituto Brasileiro de Controle do Câncer, Rua Maestro Chiaffarelli, 409, São Paulo, SP ZIP 01432-030, BrazilEmail edufleury@hotmail.comAbstract: Complications related to breast implants have received much attention recently. Breast implant-associated anaplastic large cell lymphoma, silicone-induced granuloma of breast implant capsule, and breast implant illness are the main complications reported in the medical literature. However, the literature contains limited evidence regarding the possibility of silicone implants eliciting breast carcinoma. In this manuscript, we propose a theory in which the immune response to silicone breast implant gel bleeding acts as a triggering point for tumor oncogenesis in breast tissue. This hypothesis is derived from our findings of a case of invasive and undifferentiated medullary carcinoma in a patient with a silicone breast implant. The following concepts have been used to support this theory: 1) silicone bleeding from intact breast implants; 2) metaplasia: an adaptation to injury and precursor to dysplasia and cancer; 3) T-cell dysfunction in cancer immunity; 4) inhibitory cells in the tumor microenvironment (TME); 5) morphogenesis and bauplan; and 6) concepts underlying medullary carcinoma. We propose that the inflammatory process in response to silicone particles in the pericapsular glandular tissue favors the development of cellular mutations in specialized epithelial cells. This reverse morphogenesis could have resulted in breast carcinoma of the medullary type in the present case.Keywords: breast implant-associated anaplastic large cell lymphoma, BIA-ALCL, breast implant illness, BII, silicone granuloma, breast cancer, breast implanthttps://www.dovepress.com/the-breast-tumor-microenvironment-could-silicone-breast-implant-elicit-peer-reviewed-article-BCTTbreast implant-associated anaplastic large cell lymphoma (bia-alcl)breast implant illness (bii)silicone granulomabreast cancerbreast implanttumor microenvironment (tme)immunologyt cells
spellingShingle Fleury E
Nimir C
D'Alessandro GS
The Breast Tumor Microenvironment: Could Silicone Breast Implant Elicit Breast Carcinoma?
Breast Cancer: Targets and Therapy
breast implant-associated anaplastic large cell lymphoma (bia-alcl)
breast implant illness (bii)
silicone granuloma
breast cancer
breast implant
tumor microenvironment (tme)
immunology
t cells
title The Breast Tumor Microenvironment: Could Silicone Breast Implant Elicit Breast Carcinoma?
title_full The Breast Tumor Microenvironment: Could Silicone Breast Implant Elicit Breast Carcinoma?
title_fullStr The Breast Tumor Microenvironment: Could Silicone Breast Implant Elicit Breast Carcinoma?
title_full_unstemmed The Breast Tumor Microenvironment: Could Silicone Breast Implant Elicit Breast Carcinoma?
title_short The Breast Tumor Microenvironment: Could Silicone Breast Implant Elicit Breast Carcinoma?
title_sort breast tumor microenvironment could silicone breast implant elicit breast carcinoma
topic breast implant-associated anaplastic large cell lymphoma (bia-alcl)
breast implant illness (bii)
silicone granuloma
breast cancer
breast implant
tumor microenvironment (tme)
immunology
t cells
url https://www.dovepress.com/the-breast-tumor-microenvironment-could-silicone-breast-implant-elicit-peer-reviewed-article-BCTT
work_keys_str_mv AT fleurye thebreasttumormicroenvironmentcouldsiliconebreastimplantelicitbreastcarcinoma
AT nimirc thebreasttumormicroenvironmentcouldsiliconebreastimplantelicitbreastcarcinoma
AT dalessandrogs thebreasttumormicroenvironmentcouldsiliconebreastimplantelicitbreastcarcinoma
AT fleurye breasttumormicroenvironmentcouldsiliconebreastimplantelicitbreastcarcinoma
AT nimirc breasttumormicroenvironmentcouldsiliconebreastimplantelicitbreastcarcinoma
AT dalessandrogs breasttumormicroenvironmentcouldsiliconebreastimplantelicitbreastcarcinoma