Breast implant-associated squamous cell carcinoma: an evidence-based systematic review

Background With the recent safety communication issued by The Food and Drug Administration, squamous cell carcinoma breast-implant associated (BIA-SCC) has become part of the breast implant capsule related conditions. In the present paper, we review all cases of BIA-SCC currently reported in the literature. Methods From October 2022 to February 2023, we conducted a systematic review of the literature in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement. An electronic search was performed using PubMed/Medline, Scopus, and Cochrane Database. Only manuscripts written in English and featuring one or more clinical cases of BIA-SCC were included for full-text analysis. Results Eight-hundred-sixty-seven articles were identified. After excluding duplicates, irrelevant and non-English-written papers, fifteen articles were deemed eligible for the review, featuring a total of eighteen cases. Eleven patients received bilateral breast augmentation, five bilateral or unilateral reconstruction either following mastectomy or for Poland syndrome, while in two cases the indication for implant placement was not reported. Time from implantation to clinical onset was less than ten years in three patients, over ten years in thirteen instances and not reported in two. History of capsular contracture was identified in eight patients, while complications including previous surgical revisions, implant exchange or exposure, extrusion or infection were reported in eight cases. Conclusions The paucity of literature on BIA-SCC still hinders us from drawing definitive conclusions. Nevertheless, we can infer that early detection of symptoms is pivotal in the decision-making process for the treatment and management of this nosological entity. Level of evidence: Not gradable