LITERATURE UPDATE
Breast implant surface topography triggers a chronic-like inflammatory response Vinci V, Belgiovine C, Janszen G et al. Life Sci Alliance. 2024 Feb 21; 7 (5): e202302132. doi: 10.26508/ lsa.202302132.
Breast implants are extensively employed for both reconstructive and aesthetic purposes. However, the safety of breast implants with textured surfaces has been questioned, owing to a potential correlation with anaplastic large-cell lymphoma and the recurrence of breast cancer.
This study investigates the
Textured implants, the main risk factor for the development of breast implant-associated anaplastic large- cell lymphoma.
Marques-Piubelli ML, Lyapichev KA, Fnu A et al. Am J Surg Pathol. 2024 Jun 1; 48 (6): e43-e64. doi: 10.1097/ PAS.0000000000002198.
Breast implant-associated anaplastic large cell lymphoma has been recognised as a distinct entity in the World Health Organization classification of haematolymphoid neoplasms. These neoplasms are causally related to textured implants that were used worldwide until recently. Consequently, there is an increased demand for processing periprosthetic capsules, adding new challenges for surgeons, clinicians, and pathologists. In the literature, the focus has been
on breast implant-associated anaplastic large cell lymphoma; however, benign complications related to the placement of breast implants occur in up to 20–30%
of patients. Imaging studies are helpful in assessing patients with breast implants for evidence of implant rupture, changes in tissues surrounding the implants, or regional lymphadenopathy related to breast implants, but pathologic examination is often required. In this review, the authors couple their experience with a review of the literature to describe a range of benign lesions associated with breast implants that can be associated with different clinical presentations or pathogenesis and that may require different diagnostic approaches. They illustrate the spectrum of the most common of these benign disorders, highlighting their clinical, imaging, gross, and microscopic features. Finally, they propose a systematic approach for the diagnosis and handling of breast implant specimens in general.
immune response elicited by different prosthetic surfaces, focusing on the comparison between macrotextured and microtextured breast implants. Through the analysis of intraoperatively harvested periprosthetic fluids and cell culture experiments on surface replicas, the authors demonstrate that macrotextured surfaces elicit a more pronounced chronic-like activation of leucocytes and an increased release of inflammatory cytokines, in contrast to microtextured surfaces. In addition, in vitro fluorescent imaging of leucocytes revealed an accumulation of lymphocytes within the cavities of the macrotextured surfaces, indicating that the physical entrapment of these cells may contribute to their activation.
These findings suggest that the topography of implant surfaces plays a significant role in promoting a chronic- like inflammatory environment, which could be a contributing factor in the development of lymphomas associated with a wide range of implantable devices.
BIA-ALCL and BIA-SCC: Updates on Clinical Features and Genetic Mutations for Latest Recommendations D’Orsi G, Giacalone M, Calicchia A et al. Medicina (Kaunas). 2024 May 10; 60 (5): 793. doi: 10.3390/medicina60050793.
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