Massive inflammatory reaction following the removal of a ruptured silicone implant masking the invasive breast cancer - case report and literature review

Abstract

This paper presents a case of a patient with invasive ductal breast cancer following breast augmentation. Following breast implants rupture in March 2013 the breast implants have been removed - histopathological examination revealed leaked silicone with inflammatory infiltration, without evidence of cancerous lesions. Diagnostic imaging revealed multiple encapsulated silicone particles and clusters of post-inflammatory macrocalcifications in both breasts. In January 2014 the patient presented with symptoms of massive inflammation of the left breast. Following surgical consultation the patient had undergone radical left-sided mastectomy with lymphadenectomy. Postoperative histopathological examination revealed a multifocal advanced invasive ductal cancer G3 pT3pN3a (vascular invasion, metastases in 11 of 12 examined axillary lymph nodes). Following surgery the patient was qualified for further treatment - chemotherapy, radiotherapy, hormone therapy. The discussion includes a review of literature on the risk evaluation of co-occurrence of breast cancers in women with silicone breast implants and presents diagnostic challenges of breast cancer in this patient group.