Breast implant illness after reconstruction with silicone breast implants

• Published in: JNCI : Journal of the National Cancer Institute Vol. 117; no. 8; pp. 1717 - 1728
• Main Authors: Spoor, Jonathan, Mureau, Marc A M, Tissier, Renaud L M, Hommes, Juliëtte, Rakhorst, Hinne, de Boer, Mintsje, Oldenburg, Hester S A, Heuts, Esther M, Vissers, Yvonne L J, Dassen, Anneriet E, Evers, Daniel J, Koppert, Linetta B, Zaal, Laura H, Linn, Sabine C, de Jong, Daphne, van der Hulst, Rene R W J, Vrancken Peeters, Marie-Jeanne T F D, Bleiker, Eveline M A, van Leeuwen, Flora E
• Format: Journal Article
• Language: English
• Published: United States Oxford Publishing Limited (England) 01.08.2025; Oxford University Press
• Subjects: Adult; Aged; Arthralgia; Biomechanics; Breast cancer; Breast Implantation - adverse effects; Breast implants; Breast Implants - adverse effects; Breast Neoplasms - surgery; Cancer Survivors - statistics & numerical data; Clusters; Exposure; Female; Follow-Up Studies; Humans; Illnesses; Implants; Mammaplasty - adverse effects; Middle Aged; Netherlands - epidemiology; Pain; Patients; Population studies; Regression analysis; Regression models; Risk; Silicone Gels - adverse effects; Silicones; Silicones - adverse effects; Survival; Well being; Netherlands
• ISSN: 0027-8874; 1460-2105; 1460-2105
• DOI: 10.1093/jnci/djaf136

"Breast implant illness" (BII) is a constellation of non-specific constitutional, rheumatologic, mental, and cognitive symptoms reported increasingly by women carrying silicone breast implants (SBIs). The impact of BII on the well-being of breast cancer patients with SBI-based breast reconstructions is a subject of debate. In a multicenter cohort of breast cancer survivors (n = 9590) treated between 2000 and 2015 in 6 major regional hospitals in the Netherlands, we performed a health survey (response rate 64.7%). The presence of 18 BII-associated symptoms was compared between patients with and without SBIs in multivariable logistic regression models. In a latent class analysis (LCA), distinct symptom patterns were identified in the study population. Median follow-up time was 13.7 (IQR, 6.8) years. Of all SBI-exposed patients (n = 1821), 20.7% reported ≥4 BII-associated symptoms vs 21.2% of non-exposed patients (risk ratio 0.98; 95% CI = 0.88 to 1.09). Joint pain, sicca, sleep impairment, morning stiffness, and shoulder pain were reported most frequently. Patients with SBIs did not have a significantly increased risk of any of the individual BII-associated symptoms. The LCA identified 5 distinct symptom clusters. Patients with SBI-exposure had a lower risk of falling in the most severe symptom cluster (odds ratio 0.64; 95% CI = 0.43 to 0.96). The other symptom clusters were not significantly associated with SBI-exposure. Our results indicate that breast cancer survivors with SBI-based reconstructions do not experience more BII-associated symptoms than breast cancer survivors without SBIs, challenging the notion of BII as a distinct clinical entity based on a generic silicone-induced biomechanical pathophysiological mechanism. This study was preregistered at ClinicalTrials.gov on June 2, 2022 (NCT05400954).