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Squamous Cell Carcinoma And Breast Implants: A Contextualized Risk Assessment Through Epidemiology And Systematic Review
Fabio Santanelli di Pompeo, MD PhD1, Mark W. Clemens, MD PhD
2, Guido Firmani, MD
1, Christian Napoli, MD PhD
1, Michail Sorotos, MD PhD
1;
1Sapienza, Rome, Italy,
2MD Anderson Cancer Center University of Texas, Houston, TX, USA
PURPOSE: Squamous cell carcinoma (SCC) emerges adjacent to breast implants, termed breast implant-associated SCC (BIA-SCC), and from breast tissue itself, primary SCC of the breast (PSCCB). We collate all cases of BIA-SCC through a systematic review and juxtapose the associated risk for the US population with that of PSCCB and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).
METHODS: From September 2022 to June 2023, all publications on BIA-SCC were searched on Pubmed, Web of Science, Google Scholar and Cochrane Library to identify publications related to BIA-SCC. The risk denominators, derived from the US breast implant population and incorporating texture-specific implant data and female transgenders, catered to BIA-SCC and BIA-ALCL risk calculations, while the US female demographic served as the reference for PSCCB. Risks were calculated as the ratio of total cases to the at-risk population, per 100,000 individuals.
RESULTS: From 10,176 initial entries, 24 manuscripts were included, revealing 30 BIA-SCC cases, (25 into the US) with a risk of 1:171,505 individuals with breast implants, which was 3.46x less frequent than PSCCB’s risk of 1:49,509 individuals, and 187.8x less frequent than BIA-ALCL’s risk of 1:913 individuals with textured implants (P < 0.001).
CONCLUSION: This findings underscores the importance of a balanced perspective on breast implants-associated risks and highlights the necessity of evidence-based patient counseling. BIA-SCC remains very rare in the spectrum of breast implant-associated malignancies, particularly BIA-ALCL or PSCCB. By providing this context, surgeons and patients can approach breast augmentation decisions with well-informed clarity, ensuring choices are grounded in current epidemiology.
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