Melinda HAWS 医师
整形外科医师
其他作者: Includes review of papers published by Caroline Glicksman MD and Pat McGuire MD
Current status of BIA-ALCL, BIA-SCC, and BII in the US
Objectives: To update the audience on latest research in BII as well as current FDA counts of SCC and ALCL with breast implants and how this is incorporated into a breast implant consult so that the patient is well educated and can make informed decisions
Introduction: The FDA is still tracking cases of BIA SCC and BIA ALCL world wide. Incidence and mortality data will be reviewed. In addition, review of 5 papers funded by ASERF published in ASJ regarding systemic symptoms with breast implants will be reviewed
Materials / method: Review of FDA website data and its implications. Review of the four papers on SSBI (BII) in the 150 patient initial study as well as the 100 patients in the follow up no capsulectomy study will be reviewed.
Results: The FDA still Indicates a low incidence of BIA SCC, and never found in a normal capsule. The FDA indicates there are still deaths occurring from BIA ALCL despite evidence to show a very curable disease if discovered early.
The SSBI (BII) papers found no cause for symptoms in the SSBI group as compared to the 2 control groups. Pathology, heavy metals, and microbiology were all performed on the capsules. Serum levels of various cytokines, endotoxins or other abnormalities were not found. In the BII cohort there was a significant drop off of symptoms after implant removal
Conclusion: Practioners should still watch and testfor BIA ALCL and SCC. Patients complaining of SSBI (BII) have statistically symptom improvement after implant removal despite negative causative findings regardless of whether capsule is removed or not. The only symptom that never approaches baseline is anxiety. True incidence of BIA SCC and BIA ALCL and their warning signs as well as occurrence of SSBI(BII) should be discussed with preop breast implant patients. Higher anxiety levels in those SSBI patients should be discussed, particularly in patients with preexisting anxiety.