A Systematic Review of Breast Implant-Associated Squamous Cell Carcinoma

SIMPLE SUMMARY: Breast augmentation is a widely performed procedure worldwide and is considered safe. However, there is a concerning rise in rare cases of cancers associated with breast implants, including lymphoma and squamous cell carcinoma. Both the American Society of Plastic Surgeons (ASPS) and the FDA have issued warnings about these risks. Our comprehensive study of reported cases of breast implant associated squamous cell carcinoma (BIA-SCC) reveals that the treatment approaches for these conditions vary, and sadly, some patients have a short life expectancy after diagnosis. This emphasizes the critical need for enhanced monitoring and information sharing to detect and effectively manage BIA-SCC. Healthcare providers must maintain vigilance when conducting long-term follow-ups with patients who have undergone breast augmentation surgery. ABSTRACT: Breast augmentation is considered safe, but rare cases of breast implant-associated squamous cell carcinoma (BIA-SCC) have been reported. This study aimed to systematically review published cases of BIA-SCC, providing valuable clinical data. The review included 14 articles and 18 cases of BIA-SCC. An increasing trend in reported BIA-SCC cases was observed, with four cases in the 1990s and 14 cases since 2010. The mean age of affected patients was 56 years, and symptoms typically appeared around 21 years after breast augmentation. Silicone implants used in cosmetic procedures were most commonly associated with BIA-SCC. Implant removal was necessary in all cases, and some patients required a mastectomy. Treatment approaches varied, with the selective use of chemotherapy and/or radiotherapy. The estimated 6-month mortality rate was 11.1%, while the 12-month mortality rate was 23.8%. The estimated 6-month mortality rate should be cautiously interpreted due to the limited sample size. It appears lower than the rate reported by the American Society of Plastic Surgeons, without clear reasons for this discrepancy. This study highlights the importance of enhanced monitoring and information sharing to improve detection and management of BIA-SCC. Healthcare providers should maintain vigilance during the long-term follow-up of breast augmentation patients.