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Ouyang R, Lin X, Hu J, Li L, Ma J. Misdiagnosis of breast cancer after augmentation injection of stromal vascular fraction gel: a case description. Quant Imaging Med Surg 2023; 13:496-501. [PMID: 36620136 PMCID: PMC9816752 DOI: 10.21037/qims-22-165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 08/25/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Rushan Ouyang
- Department of Radiology, The Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen, China
| | - Xiaohui Lin
- Department of Radiology, The Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen, China
| | - Jintao Hu
- Department of Pathology, The Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen, China
| | - Lin Li
- Department of Radiology, The Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen, China
| | - Jie Ma
- Department of Radiology, The Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen, China
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Verras GI, Tchabashvili L, Mulita F, Grypari IM, Sourouni S, Panagodimou E, Argentou MI. Micropapillary Breast Carcinoma: From Molecular Pathogenesis to Prognosis. BREAST CANCER (DOVE MEDICAL PRESS) 2022; 14:41-61. [PMID: 35310681 PMCID: PMC8926414 DOI: 10.2147/bctt.s346301] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/29/2022] [Indexed: 02/05/2023]
Abstract
Invasive micropapillary carcinoma (IMPC) of the breast is an infrequent type of breast cancer often discussed for its potency for lymphovascular invasion and difficulty in accurate imaging estimation. Micropapillary carcinomas are noted to be present as larger tumors, of higher histological grade and a notably higher percentage of disease-positive lymph nodes. Hormonal and HER-2 positivity in IMPC is also commoner when compared to other NST carcinomas. IMPC occurs either as a pure form or more often as a component of mixed Non-Specific Type (NST) carcinoma. The latest data suggest that despite having comparable survival rates to other histological subtypes of breast carcinoma, effective surgical treatment often requires extended surgical margins and vigilant preoperative axillary staging due to an increased incidence of lymph node invasion, and locoregional recurrence. Moreover, the presence of micropapillary in situ components within tumors also seems to alter tumor aggression and influence the nodal disease stage. In this review, we present an overview of the current literature of micropapillary carcinoma of the breast from biology to prognosis, focusing on biological differences and treatment.
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Affiliation(s)
| | - Levan Tchabashvili
- Department of Surgery, Breast Unit, University Hospital of Patras, Patras, Greece
| | - Francesk Mulita
- Department of Surgery, Breast Unit, University Hospital of Patras, Patras, Greece
| | | | - Sofia Sourouni
- Department of Radiology, University Hospital of Patras, Patras, Greece
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Toyonaka R, Ozeki J, Koyama Y, Takahashi S, Tang X, Kobayashi H, Amano M, Tada K, Miki T, Tani M. A case of breast squamous cell carcinoma following breast augmentation with liquid silicone injection after 16 years. Surg Case Rep 2022; 8:22. [PMID: 35089470 PMCID: PMC8799800 DOI: 10.1186/s40792-022-01378-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 01/21/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Breast augmentation has been linked to various complications, including cancerous tumors. The majority type of breast cancer associated with breast augmentation is adenocarcinoma. Primary squamous cell carcinoma (SCC) of the breast is extremely rare in both augmented and non-augmented women. Due to the low incidence, the possible origin and the mechanism of carcinogenesis of the breast SCC are not well understood. Here, we report a rare case of pure SCC 16 years after breast augmentation with liquid silicone injection. CASE PRESENTATION A 51-year-old Japanese woman was suffered from prolonged breast fluid retention in her left breast. Multiple unknown foreign bodies caused difficulties to investigate the inflammatory focus with ultrasonography. After unsuccessful surgical drainage and antibiotics treatments, the long-standing fluid retention was surgically removed and pathologically investigated. SCC was found in the removed tissue, and the patient underwent a total left mastectomy followed by postoperative chemotherapy. Pathological analysis revealed multiple cystic structures with a hard shell which enclosed high viscous liquid. A qualitative analysis using a Fourier transform infrared spectroscope defined the liquid as pure silicon, which possibly caused the squamous cell carcinogenesis. CONCLUSIONS Although liquid silicone injection is not a current option for breast augmentation, the injected silicone could result in cancerous tumor generation after years. This case revealed that unphysiological substances could lead to unexpected biological reactions, which caused difficulties in diagnosis with our routine examination. It will be required that accumulate information from more cases and develop novel diagnostic equipment and biomarkers to address these artificial substance-derived tumors.
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Affiliation(s)
- Ryosuke Toyonaka
- Department of Digestive Surgery, School of Medicine, Nihon University, 30-1 Oyaguchi Kamicho, Itabashi-ku, Tokyo, Japan
| | - Jun Ozeki
- Division of Breast and Endocrine Surgery, Department of Surgery, Nihon University Hospital, 1-6 Kandasurugadai, Chiyoda-ku, Tokyo, Japan
| | - Yumi Koyama
- Division of Breast and Endocrine Surgery, Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kamicho, Itabashi-ku, Tokyo, Japan
| | - Saaya Takahashi
- Division of Breast and Endocrine Surgery, Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kamicho, Itabashi-ku, Tokyo, Japan
| | - Xiaoyan Tang
- Department of Pathology, Nihon University Hospital, 1-6 Kandasurugadai, Chiyoda-ku, Tokyo, Japan
| | - Hiroko Kobayashi
- Department of Pathology, Nihon University School of Medicine, 30-1 Oyaguchi Kamicho, Itabashi-ku, Tokyo, Japan
| | - Maki Amano
- Department of Radiology, Nihon University Hospital, 1-6 Kandasurugadai, Chiyoda-ku, Tokyo, Japan
| | - Keiichiro Tada
- Division of Breast and Endocrine Surgery, Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kamicho, Itabashi-ku, Tokyo, Japan
| | - Toshio Miki
- Division of Biomedical Sciences, Department of Physiology, Nihon University School of Medicine, 30-1 Oyaguchi Kamicho, Itabashi-ku, Tokyo, Japan
| | - Mayumi Tani
- Division of Breast and Endocrine Surgery, Department of Surgery, Nihon University Hospital, 1-6 Kandasurugadai, Chiyoda-ku, Tokyo, Japan
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Fujimoto A, Kosaka Y, Hasebe T, Saeki T. Hidden breast cancer after breast augmentation, not presenting as a hypoechoic mass lesion, diagnosed using colour Doppler ultrasound. BMJ Case Rep 2021; 14:14/9/e242742. [PMID: 34548294 PMCID: PMC8458326 DOI: 10.1136/bcr-2021-242742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The main concern after breast augmentation with silicone injection is that silicone granulomas make it difficult to detect breast cancer. A case of breast cancer was diagnosed using colour Doppler ultrasound (CD) to detect an non-palpable mass not presenting as a hypoechoic mass lesion. An 83-year-old woman was incidentally found to have a lesion in her right breast, which was injected with silicone, showing 18F-fluorodeoxyglucose (FDG) uptake; the lesion was suspected to be breast cancer or silicone granuloma. A mass at the FDG uptake site was not detected on ultrasonography (US); however, observation using CD revealed a slightly hypoechoic area with hypervascularity. Core needle biopsy showed invasive ductal carcinoma. Patients in whom US does not reveal lesions after breast augmentation with silicone injection should undergo CD to detect hypervascularised tissue. To prevent false-negative biopsy results, CD is essential to detect cancer at suspected sites.
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Affiliation(s)
- Akihiro Fujimoto
- Breast Oncology Service, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Yoshimasa Kosaka
- Breast Oncology Service, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Takahiro Hasebe
- Breast Oncology Service, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Toshiaki Saeki
- Breast Oncology Service, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
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Xu MY, Huang Y. Ultrasound-Guided Removal of Breast Foreign Matter: A Case Report. Breastfeed Med 2019; 14:278-279. [PMID: 30990329 DOI: 10.1089/bfm.2019.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: The origins of foreign matter are almost of medical materials, and no previous cases of ultrasound-guided breast foreign matter removal have been reported. The patient was a 30-year-old female with mammary foreign matter, a horse's bristle used in the treatment conducted by the galactagogue master. Methods: Removal of mammary foreign matter under the guidance of ultrasound. Results: A horse's bristle in the breast that was successfully removed with the guidance of ultrasound and the overall process of the operation went smoothly and took minutes. Conclusions: Ultrasonography is the first line of breast disease examination and the future will present many new treatment opportunities of interventional ultrasound.
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Affiliation(s)
- Meng-Ying Xu
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ying Huang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
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Moling O, Piccin A, Tauber M, Marinello P, Canova M, Casini M, Negri G, Raffeiner B, Binazzi R, Gandini L, Vecchiato C, Rimenti G, Billio A. Intravascular large B-cell lymphoma associated with silicone breast implant, HLA-DRB1*11:01, and HLA-DQB1*03:01 manifesting as macrophage activation syndrome and with severe neurological symptoms: a case report. J Med Case Rep 2016; 10:254. [PMID: 27634631 PMCID: PMC5025582 DOI: 10.1186/s13256-016-0993-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 07/05/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Silicone implants have been successfully used for breast augmentation and reconstruction in millions of women worldwide. The reaction to the silicone implant is highly variable; it can lead to local inflammatory symptoms, and sometimes to systemic symptoms and disease. Over 80 cases of anaplastic lymphoma kinase-negative anaplastic large cell lymphoma have been reported in patients with silicone breast implants and have been accepted as a new clinical entity. To the best of our knowledge, an intravascular large B-cell lymphoma associated with a silicone breast implant has not been reported previously. CASE PRESENTATION A 48-year-old Caucasian woman who presented with high fever was found to have splenomegaly on physical examination. A laboratory diagnosis revealed pancytopenia, hypertriglyceridemia, and hyperferritinemia. She developed signs of altered sensorium, hemiparesis, aphasia, and cauda equina syndrome. On further evaluation, she fulfilled the necessary five out of eight criteria for diagnosis of macrophage activation syndrome/hemophagocytic lymphohistiocytosis. Dexamethasone administration was followed by prompt improvement; however, 3 days later she again manifested high fever, which persisted despite administration of immunoglobulin and cyclosporine A. Her silicone breast implant was considered a possible contributor to her macrophage activation syndrome and was therefore removed. A histological examination of the capsule tissue showed an extensive lymphohistiocytic/giant cell foreign body reaction suggestive of autoimmune/inflammatory syndrome induced by adjuvants. However, the histological examination unexpectedly also revealed an intravascular large B-cell lymphoma. CONCLUSIONS The genetic background of our patient with silicone breast implants might have predisposed her to three rare and difficult to diagnose syndromes/diseases: macrophage activation syndrome/hemophagocytic lymphohistiocytosis, autoimmune/inflammatory syndrome induced by adjuvants, and intravascular large B-cell lymphoma. The simultaneous manifestation of all three syndromes suggests causal interrelationships. Human leukocyte antigen testing in all women who undergo silicon breast implantation could in the future enable us to better evaluate the risk of potential side effects.
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Affiliation(s)
- Oswald Moling
- Division of Infectious Diseases, Ospedale Generale, 39100, Bolzano, Italy.
| | - Andrea Piccin
- Department of Hematology, Ospedale Generale, 39100, Bolzano, Italy
| | - Martina Tauber
- Department of Pathology, Ospedale Generale, 39100, Bolzano, Italy
| | - Peter Marinello
- Department of General Surgery, Ospedale Generale, 39100, Bolzano, Italy
| | - Mariagrazia Canova
- Rheumatology Unit, Department of Medicine, Ospedale Generale, 39100, Bolzano, Italy
| | - Marco Casini
- Department of Hematology, Ospedale Generale, 39100, Bolzano, Italy
| | - Giovanni Negri
- Department of Pathology, Ospedale Generale, 39100, Bolzano, Italy
| | - Bernd Raffeiner
- Rheumatology Unit, Department of Medicine, Ospedale Generale, 39100, Bolzano, Italy
| | - Raffaella Binazzi
- Division of Infectious Diseases, Ospedale Generale, 39100, Bolzano, Italy
| | - Latha Gandini
- Division of Infectious Diseases, Ospedale Generale, 39100, Bolzano, Italy
| | - Cinzia Vecchiato
- Laboratory of Immunogenetics, Transfusion Medicine Service, Ospedale Generale, 39100, Bolzano, Italy
| | - Giovanni Rimenti
- Division of Infectious Diseases, Ospedale Generale, 39100, Bolzano, Italy
| | - Atto Billio
- Department of Hematology, Ospedale Generale, 39100, Bolzano, Italy
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Nakahori R, Takahashi R, Akashi M, Tsutsui K, Harada S, Matsubayashi RN, Nakagawa S, Momosaki S, Akagi Y. Breast carcinoma originating from a silicone granuloma: a case report. World J Surg Oncol 2015; 13:72. [PMID: 25888835 PMCID: PMC4350903 DOI: 10.1186/s12957-015-0509-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 02/09/2015] [Indexed: 11/17/2022] Open
Abstract
Breast carcinoma rarely occurs in cases of foreign body granulomas following liquid silicone injection. Although the Food and Drug Administration (FDA) banned the use of all silicone injection products in 1992, liquid silicone injection for breast augmentation continues to be performed illegally. We herein report a case of breast carcinoma following liquid silicone injection in a 67-year-old female. A total of 45 years after liquid silicone injection, the patient had felt a breast mass in the right breast. Mammography showed a smooth mass that retracted the right nipple. Due to the presence of a marked acoustic shadow caused by the granulomas, evaluating the mass on ultrasonography was difficult. However, magnetic resonance imaging (MRI) showed a lobulated mass under the right nipple. The mass exhibited low signal intensity (SI) on T1-weighted images and intermingled high and low SI on T2-weighted images. Heterogeneous early enhancement with central low intensity was noted on dynamic contrast-enhanced MRI. Several oval-shaped low SI structures in the adipose tissue and disruption of the pectoralis major muscle were also observed. We diagnosed the patient with invasive ductal carcinoma based on a stereotactic-guided Mammotome® (a vacuum-assisted biopsy system manufactured by DEVICOR MEDICAL JAPAN, Tokyo, Japan) biopsy and subsequently performed mastectomy and axillary lymph node dissection (with a positive result for the sentinel node biopsy). Histologically, invasive ductal carcinoma was observed in the silicone granuloma. The development of foreign body granulomas following breast augmentation usually makes it difficult to detect breast cancer; thus, various devices are required to confirm the histological diagnosis of breast lesions. The stereotactic-guided Mammotome® biopsy system may be an effective device for diagnosing breast cancer developing in the augmented breast.
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Affiliation(s)
- Ryoichi Nakahori
- Department of Breast Care Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuou-ku, Fukuoka, Japan. .,Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Chigyouhama, Chuou-ku, Fukuoka, Japan.
| | - Ryuji Takahashi
- Department of Breast Care Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuou-ku, Fukuoka, Japan. .,Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Chigyouhama, Chuou-ku, Fukuoka, Japan.
| | - Momoko Akashi
- Department of Breast Care Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuou-ku, Fukuoka, Japan. .,Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Chigyouhama, Chuou-ku, Fukuoka, Japan.
| | - Kana Tsutsui
- Department of Breast Care Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuou-ku, Fukuoka, Japan. .,Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Chigyouhama, Chuou-ku, Fukuoka, Japan.
| | - Shino Harada
- Department of Breast Care Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuou-ku, Fukuoka, Japan. .,Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Chigyouhama, Chuou-ku, Fukuoka, Japan.
| | - Roka Namoto Matsubayashi
- Department of Breast Care Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuou-ku, Fukuoka, Japan. .,Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Chigyouhama, Chuou-ku, Fukuoka, Japan.
| | - Shino Nakagawa
- Department of Breast Care Center, National Hospital Organization Kyushu Medical Center, 1-8-1 Jigyohama, Chuou-ku, Fukuoka, Japan. .,Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Chigyouhama, Chuou-ku, Fukuoka, Japan.
| | - Seiya Momosaki
- Clinical Research Institute, National Hospital Organization Kyushu Medical Center, 1-8-1 Chigyouhama, Chuou-ku, Fukuoka, Japan. .,Department of Pathology, National Hospital Organization Kyushu Medical Center, 1-8-1 Chigyouhama, Chuou-ku, Fukuoka, Japan.
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Kurume, Japan.
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Martis JJS, Rajeshwara KV, Murulya KS, Raghavendra BK, Alex KM. A rare cause of jejunojejunal intussusception in an adult. Indian J Surg 2011; 75:18-20. [PMID: 24426499 DOI: 10.1007/s12262-011-0295-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2010] [Accepted: 02/15/2011] [Indexed: 12/17/2022] Open
Abstract
Jejunojejunal intussusceptions are not common in adults and unlike in children, a lead point is usually found. The clinical presentation in adults tends to be more chronic or intermittent and include abdominal pain, obstructive symptoms, gastrointestinal bleeding or palpable mass. These unspecific symptoms often lead to a late diagnosis. The clinical picture is subtle and diagnosis is therefore elusive. We report a case of jejunojejunal intussusception secondary to gastrointestinal stromal tumor (GIST) in a 50 year old female.
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Affiliation(s)
- John J S Martis
- Department of Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore, 575002 Karnataka State India
| | - K V Rajeshwara
- Department of Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore, 575002 Karnataka State India
| | - Kalpana S Murulya
- Department of Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore, 575002 Karnataka State India
| | - B K Raghavendra
- Department of Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore, 575002 Karnataka State India
| | - Kavitha Mary Alex
- Department of Surgery, Fr. Muller Medical College Hospital, Kankanady, Mangalore, 575002 Karnataka State India
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Cheng NX, Liu LG, Hui L, Chen YL, Xu SL. Breast cancer following augmentation mammaplasty with polyacrylamide hydrogel (PAAG) injection. Aesthetic Plast Surg 2009; 33:563-9. [PMID: 19156460 DOI: 10.1007/s00266-008-9298-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2008] [Accepted: 12/02/2008] [Indexed: 10/21/2022]
Abstract
Polyacrylamide hydrogel (PAAG) as an implanted material for augmentation mammaplasty has been used for years in China. Many kinds of complications associated with PAAG use have been reported in the clinical literature. This report presents two cases of breast cancer occurring after injection of PAAG in augmented breasts. The delayed diagnosis and more aggressive disease due to PAAG injection should be cause for concern. It is very important to detect breast cancer early when it is covered by the induration of the injected gel and inflammation reaction after PAAG injection. PAAG injection for augmentation mammaplasty may affect the outcome of breast cancer diagnosis and prognosis.
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Alikhan MB, Nassar A, Mansoor I. Squamous metaplasia on the breast implant capsule. Int J Surg Pathol 2009; 18:570-4. [PMID: 19147510 DOI: 10.1177/1066896908329587] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The development of squamous metaplasia or carcinoma is a rare occurrence in the setting of a ruptured or leaking silicone breast implant capsule. However, the oncogenic process in such a context is yet another intriguing example of how chronic inflammation plays an integral role in the tumorigenic process. Recent papers have shed light on how inflammation involving M2-tpe macrophages, lymphocytes, and other inflammatory cells at first provide the cytokines necessary to fend off an inciting foreign-body attack such as silicone from a ruptured or leaking implant. Although such a response is beneficial in keeping infection or foreign material in check, there are instances when the response may be exaggerated. It is thought that the extent and length of the response, the balance between pro-inflammatory/ anti-apoptotic and anti-inflammatory/pro-apoptotic, as well as genetic factors play important roles in determining the final result of an inflammatory insult.
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Affiliation(s)
- Mir Basharath Alikhan
- Department of Pathology, Hospital Clínico Universitario, SERGAS, University of Santiago de Compostela, Galicia.
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