Diagnosis, investigation and management of breast implant illness

Daniel Wh Wong,Tai K Lam

doi:10.34239/ajops.v4n1.210

Daniel Wh Wong, Tai K Lam

Open Access

https://doi.org/10.34239/ajops.v4n1.210

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Abstract

Introduction: An increasing pool of literature proposes a link between silicone implants and autoimmune-related symptoms known colloquially as breast implant illness (BII). We describe the history of BII, reported symptoms, risk factors and previously published diagnostic criteria to aid clinicians in the diagnosis, investigations and management of patients presenting with symptoms that they attribute to their silicone breast implants. Methods: A literature search was performed using MEDLINE®, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effect (DARE) and PubMed in September 2018. The search terms ‘autoimmune inflammatory syndrome induced by adjuvants’, ‘breast implants’ and ‘silicone’ were used alone and in combination. Results: Thirty-four studies were reviewed including three case reports, 12 case series, 14 retrospective cohort studies, four case control studies and one prospective cohort study. Within this cohort, 18 studies were found regarding the explantation of implants relating to BII. Conclusion: Studies have demonstrated no association between silicone breast implants and any known autoimmune diseases, but there exists a pool of literature suggestive of a relatively undefined condition colloquially known as BII. Serological testing and imaging play an important role in the assessment of patients to exclude other pathology, but these tests remain non-diagnostic for BII. Although medical treatment has shown promise, there is no established treatment for patients. The surgical explantation of implants appears to have positive outcomes for patients; however, the exact nature of the surgery required to achieve this remains unclear.

Highlights

An increasing pool of literature proposes a link between silicone implants and autoimmune-related symptoms known colloquially as breast implant illness (BII)
Over the past 20 years, there has been an increasing pool of literature proposing a link between silicone implants and autoimmunerelated symptoms[3] known colloquially as breast implant illness (BII)
This association was reported as early as 1964 by Miyoshi and colleagues[4] and has various names including human adjuvant disease, silicone implant incompatibility syndrome and, more recently, autoimmune inflammatory syndrome induced by adjuvants (ASIA).[5]

Summary

Introduction

An increasing pool of literature proposes a link between silicone implants and autoimmune-related symptoms known colloquially as breast implant illness (BII). Over the past 20 years, there has been an increasing pool of literature proposing a link between silicone implants and autoimmunerelated symptoms[3] known colloquially as breast implant illness (BII). This association was reported as early as 1964 by Miyoshi and colleagues[4] and has various names including human adjuvant disease, silicone implant incompatibility syndrome and, more recently, autoimmune inflammatory syndrome induced by adjuvants (ASIA).[5].

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Conclusion