Follicular Lymphoma Adjacent to Foreign Body Granulomatous Inflammation and Fibrosis Surrounding Silicone Breast Prosthesis

Cook, Paul D.; Osborne, Barbara M.; Connor, Robert L.; Strauss, James

doi:10.1097/00000478-199506000-00012

Cited by 84 publications

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“…31 In support of this, evidence from animal studies suggests that silicone gel is immunogenic 32 and can induce plasmacytomas in genetically predisposed mice. 33 Additionally, Cook et al 11 reported a case of follicular lymphoma, adjacent to a foreignbody granulomatous response to a silicone breast implant. It has been shown that silicone gels contain several components that are potentially biologically active, such as residual vinyl groups and platinum.…”

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confidence: 99%

“…3,4 In recent years, there have been several case reports of patients developing lymphomas in close proximity to silicone or saline breast implants. [5][6][7][8][9][10][11][12][13] Interestingly, the majority of implant-associated lymphomas were T-cell lymphomas, including anaplastic large-cell lymphoma (n ¼ 5) [5][6][7]13 and mycosis fungoides/Sézary syndrome (n ¼ 4). 8,9 In contrast, only three B-cell lymphomas were described, including a primary effusion lymphoma, a follicular lymphoma and a lymphoplasmacytic lymphoma.…”

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“…8,9 In contrast, only three B-cell lymphomas were described, including a primary effusion lymphoma, a follicular lymphoma and a lymphoplasmacytic lymphoma. [10][11][12] Furthermore, two of the patients with B-cell lymphomas presented with systemic disease at the time of diagnosis. 11,12 In this study, we present four patients with primary anaplastic large-cell lymphoma of the breast associated with a breast implant and seroma (a clinical term used to identify accumulation of fluid around the breast that is derived from serum).…”

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confidence: 99%

“…[10][11][12] Furthermore, two of the patients with B-cell lymphomas presented with systemic disease at the time of diagnosis. 11,12 In this study, we present four patients with primary anaplastic large-cell lymphoma of the breast associated with a breast implant and seroma (a clinical term used to identify accumulation of fluid around the breast that is derived from serum). We also review the five previously published cases with anaplastic large-cell lymphoma in close proximity to breast implants, to more fully characterize the clinicopathological features of this rare and unusual entity.…”

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Seroma-associated primary anaplastic large-cell lymphoma adjacent to breast implants: an indolent T-cell lymphoproliferative disorder

et al. 2008

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Non-Hodgkin lymphomas of the breast are rare, encompassing approximately 0.04-0.5% of all malignant breast tumors, and the vast majority are B-cell lymphomas. In contrast, lymphomas of T-cell phenotype have been rarely reported and some of these have been in close proximity to a breast implant. In our consultation practice, we have identified four patients with primary T-cell anaplastic large-cell lymphoma presenting adjacent to silicone or saline breast implants. All patients presented with seroma and neoplastic cells were identified in suspension in the serous fluid without solid tissue invasion. Three patients had no evidence of systemic disease (stage 1E), and one patient was not staged. The mean age of the patients was 46 years (range, 34-59 years). In all patients, the neoplastic cells had a T-cell phenotype, expressed CD30, cytotoxic granuleassociated proteins, EMA and clusterin, and were anaplastic lymphoma kinase-1-negative. Clonal T-cell receptor c-chain gene rearrangements were identified in three patients. All patients underwent capsulectomy with removal of the implant. One patient subsequently received chemotherapy and radiation therapy, and another was treated with radiation alone. The third patient received no further therapy and the fourth patient has been recently diagnosed. After a mean time of 13 months (range, 9-20 months), all three patients with follow-up were alive and well without any recurrence or systemic disease. Although the follow-up time was relatively short, our series and other reported cases suggest that primary anaplastic large-cell lymphoma adjacent to breast implants is an indolent T-cell lymphoproliferative disorder. Keywords: anaplastic large-cell lymphoma; primary lymphoma of breast; breast implant; silicone; saline Non-Hodgkin lymphomas of the breast are rare and comprise approximately 0.04-0.5% of all malignant breast tumors and 2.2% of extranodal lymphomas.

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Seroma-associated primary anaplastic large-cell lymphoma adjacent to breast implants: an indolent T-cell lymphoproliferative disorder

et al. 2008

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“…3,4 Silicone has also been reported to induce plasmacytomas in susceptible mice, 5 and several case reports of breast cancer, multiple myeloma, and lymphomas occurring in women with silicone breast implants have appeared in the literature. [6][7][8][9][10] None of these observations have been substantiated in epidemiologic studies, [11][12][13][14][15][16][17][18][19][20][21][22][23][24] and in 2000 an independent review board concluded that the available evidence does not support an association between silicone breast implants and breast carcinoma or sarcoma, multiple myeloma or lymphoma. 25 Similar conclusions have been reached by the International Agency for Research on Cancer (IARC) 26 and by other review panels.…”

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Cancer risk among Danish women with cosmetic breast implants

Friis

Hölmich

McLaughlin

et al. 2005

Intl Journal of Cancer

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The available epidemiologic evidence does not support a carcinogenic effect of silicone breast implants on breast or other cancers. Data on cancer risk other than breast cancer are limited and few studies have assessed cancer risk beyond 10-15 years after breast implantation. We extended follow-up of our earlier cohort study of Danish women with cosmetic breast implants by 7 years, yielding 30 years of follow-up for women with longest implant duration. The study population consisted of women who underwent cosmetic breast implant surgery at private clinics of plastic surgery (n 5 1,653) or public hospitals (n 5 1,110), and a control group of women who attended private clinics for other plastic surgery (n 5 1,736), between 1973-95. Cancer incidence through 2002 was ascertained using the Danish Cancer Registry. Risk evaluation was based on computation of standardized incidence ratios (SIR) and Cox proportional hazards models, adjusting for age, calendar period and reproductive history. We observed 163 cancers among women with breast implants compared to 136.7 expected based on general population rates (SIR 5 1.2; 95% confidence interval [CI] 5 1.0-1.4), during a mean follow-up period of 14.4 years (range 5 0-30 years). Women with breast implants experienced a reduced risk of breast cancer (SIR 5 0.7; 95% CI 5 0.5-1.0), and an increased risk of non-melanoma skin cancer (SIR 5 2.1; 95% CI 5 1.5-2.7). Stratification by age at implantation, calendar year at implantation and time since implantation showed no clear trends, however, the statistical precision was limited in these analyses. When excluding non-melanoma skin cancer, the SIR for cancer overall was 1.0 (95% CI 5 0.8-1.2). With respect to other site-specific cancers, no significantly increased or decreased SIR were observed. Similar results were found when directly comparing women who had implants at private clinics with women who attended private clinics for other plastic surgery, with rate ratios for cancer overall, breast cancer and non-melanoma skin cancer of 1.1 (95% CI 5 0.8-1.6), 0.7 (95% CI 5 0.4-1.3) and 1.5 (95% CI 5 0.8-2.7), respectively. In conclusion, our study lends further support to the accumulating evidence that silicone breast implants are not carcinogenic. Reasons for the consistently reported deficit of breast cancer among women with breast implants remain unclear, whereas increased exposure to sunlight may explain the excess occurrence of non-melanoma skin cancer. We found no indication of delayed diagnosis of breast cancer due to the presence of breast implants. ' 2005 Wiley-Liss, Inc.Key words: breast implants; cancer incidence; risk; epidemiology; cohort studyThe carcinogenic potential of silicone has been questioned since the 1950s when silicone and other foreign materials were found to induce sarcomas in rodents.1,2 Such foreign body carcinogenesis, however, occurs in rodents with exposure to a wide array of substances, and there is no convincing evidence that a similar risk exists in humans.3,4 Silicone has also been reported to induc...

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