Breast implant (PIP), chronic inflammation and cancer: is there a connection? Case report.

The "PIP problem", in the field of the breast augmentation, represents today a surgical epidemiological emergency. The massive media coverage produced a kind of mass fear and many women are asking for explantations. A 47 y.o. female, breasts implanted with PIP devices for breast augmentation in 1998, came to our clinic asking for explantation and excisional biopsy of a 2.5 cm nodule adjacent to the upper side of the breast implant capsule. The outcome of the pathologic examination of the excised nodule was: ductal infiltrating carcinoma of the breast, medium degree of differentiation. After 7 days from the first operation the patient underwent a skin-sparing mastectomy with axillary limphadenectomy and immediate reconstruction by a submuscular placement of implant. The surgical specimen sent for pathologic examination revealed: "granulomatous inflammation by giant cells around extraneous material, lymph nodes, negative for cancer, showed extensive accumulation of foamy macrofages containing extraneous material". The findings of foreign material in granulomas and macrophages that are the primary inflammation body defense, suggest that the chronic inflammation, coming from mammary implants subject to leakage or/and osmotic shift, increase the risk of breast cancer. We therefore suggest improving the explantation/replacement of old implants. KEY WORDS: Breast cancer, Extraneous material, Immediate breast reconstruction, Inflammation, Pip Implant.