Breast Implants And Immunomodulation: Does Peri-implant Inflammation Promote Systemic Recognition Of Breast Tumor Antigen?
Megan Fracol, MD, Nikita Shah, B.A., John Kim, M.D., David Dolivo, PHD, Seok Hong, PHD, Robert Galiano, MD, Thomas Mustoe, MD.
Northwestern, Chicago, IL, USA.
Background: Women with cosmetic breast implants have significantly lower rates of subsequent breast cancer than the general population.1 We hypothesize breast implant-induced local inflammation stimulates immunosurveillance recognition of breast tumor antigen.
Methods: Women with breast-related complaints were recruited from the senior surgeon’s patients. Sera was collected and tested via ELISA assay for antibody responses to common breast tumor antigens: BRCA2, CEA, HER-2, mammaglobin-A and MUC-1, as well as tetanus. A cohort of patients had sera collected prospectively to allow comparison of pre- and post-implant placement. Antibody response levels between long term breast implant (LTBI) and implant-naïve (IN) groups were compared with unpaired t-test. Antibody responses pre- and post-implant placement were compared with paired t-test. Statistical analysis was performed with Graphpad Prism v8.1.1.
Results: One-hundred and four women were recruited. Thirty-six (34.6%) had LTBI while 68 (65.4%) were IN. Women with LTBI had higher antibody responses than IN to mammaglobin-A (OD450 0.33 versus 0.22, p=0.003) and MUC-1 (OD450 0.42 versus 0.34, p=0.02). There was no difference in antibody responses to BRCA2, CEA, HER-2 or tetanus. In the sample of patients with longitudinal sera samples pre- and post-op, antibody responses post-implant placement were significantly increased to mammaglobin-A (mean difference 0.13, p=0.0002) and MUC-1 (mean difference 0.08, p=0.02). There was no difference in post-implant responses to BRCA2, CEA, HER-2 or tetanus.
Conclusion: Women with LTBI have higher antibody recognition of the breast tumor associated antigens mammaglobin-A and MUC1. This study provides the first evidence of implant-related immune responses to breast cancer antigens.
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