Breast Implants and Immune Modulation: Does Foreign Body-Induced Inflammation Promote Immunosurveillance of Breast Tumor Antigen?

Abstract

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 plastic surgery clinic. 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 postimplant placement. Antibody response levels between long-term breast implant (LTBI) and implant-naive (IN) groups were compared with unpaired t test. Antibody responses pre- and postimplant placement were compared with paired t test. Statistical analysis was performed with Graphpad Prism v8.0.2. RESULTS: One hundred four women were recruited. Thirty-six (34.6%) had LTBI, whereas 68 (65.4%) were IN. Women with LTBI had higher antibody responses than those with 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 postoperative, antibody responses postimplant 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 postimplant responses to BRCA2, CEA, HER-2, or tetanus. There was no difference in antibody responses between women with or without capsular contracture, with or without rupture, with or without surface texture, or with subglandular versus submuscular placement. CONCLUSION: Women with LTBI have higher antibody recognition of breast tumor-associated antigens mammaglobin-A and MUC1. This study provides the first evidence of implant-related immune responses to breast cancer antigens. REFERENCE: 1. Noels EC, Lapid O, Lindeman JHN, et al. Breast implants and the risk of breast cancer: a meta-analysis of cohort studies. Aesthetic Surg J. 2015;35:55–62.