Breast Implant Associated-Squamous Cell Carcinoma (BIA-SCC) was first published in September 2022.
It is very rare but potentially aggressive tumour which is associated with breast implants and originates from the capsule. Due to the very small number of reported cases, it is difficult to determine what factors increase patient risks.
BIA-SCC pathology shows sheets of squamous cells lining the capsule in nests and bundles and it can exhibit highly invasive properties, including spread to lymph nodes, local tissues and distant sites. It is important to mention that BIA-SCC is not a breast cancer of the breast tissue.
To date, and as reported by the American Society of Plastic Surgeons, there has only been 16 cases reported in the literature and 2 other cases reported by individual surgeons. The lifetime risk of BIA-SCC is unknown. The average time for BIA-SCC following initial breast implants insertion is 22.7 years and age range in patients who present is 40-81 years.
The breast implant surface has no influence on whether the patient develops BIA-SCC, and it has been reported in patients who have had smooth and/or textured breast implants.
It can present with a delayed build of fluid (seroma), one sided swelling, pain, redness, and capsular contracture (hardening of the breast).
Investigation will include a breast ultrasound to evaluate for peri-prosthetic (around the breast implant) fluid which can be aspirated. The aspirate fluid can undergo pathological investigation with immunohistochemical stains. Other investigation includes MRI scan with or including contrast to evaluate the capsule and rule out mass in addition to PET-CT scan to stage the disease.
The treatment recommendation will be based on emerging data. Currently, explanation of the breast implant/s with complete capsulectomy will provide the best outcomes. Based on the limited medical literature it appears that incomplete resection of the breast capsule/s can result in the early/or aggressive recurrence of BIA-SCC. The approach to the treatment is multidisciplinary.
BIA-SCC must be discussed with any patient who is considering breast implants surgery as part of the informed consent process. It is imperative that they have all the relevant and up to date information relating to breasts implants in order that they can make the right choice based on current evidence and scientific basis.
In the UK this condition is reportable to MHRA. For up-to-date information regarding BIA-SCC please click on the link below as the information relating to it is in continuous state of flux.
https://www.gov.uk/government/publications/squamous-cell-carcinoma-scc-and-different-types-of-lymphomas-occurring-in-the-capsule-around-breast-implants/squamous-cell-carcinoma-scc-and-different-types-of-lymphomas-occurring-in-the-capsule-around-breast-implants
