University of Miami, Miami, Florida, USA.
Universidade Federal do Vale do São Francisco, Petrolina, Brazil.
Breast J. 2021 Oct;27(10):768-775. doi: 10.1111/tbj.14276. Epub 2021 Aug 27.
Studies suggest that surgical breast augmentation with implants is a risk factor for breast desmoid tumors. The statistical strength of this correlation is unknown, as evidence is limited to anecdotal reports.
Patients with breast desmoid tumors and a history of breast implants seen at a single center between 2000 and 2021 were identified via radiology, breast, and sarcoma databases. The standardized incidence ratio (SIR) was calculated to assess the correlation between breast desmoid tumors and breast implants. The cases were pooled with published cases for analyses. Progression-free survival curves and hazard ratios were estimated using the Kaplan-Meier method and Cox proportional-hazards modeling.
Fourteen patients from one institution and 66 cases in the literature were identified. All patients were female, and the mean age was 38 years old (range 20-66). 63 patients (82%) underwent resection, 9 (12%) received chemotherapy, 3 (4%) received sorafenib, 11 (14%) received hormonal therapy, and 3 (4%) underwent active surveillance. After resection, the 2-year recurrence-free survival rate was 77% (95% CI 65%-89%). The recurrence risk was lower for resection with no residual tumor (R0) compared to microscopic (R1) or macroscopic (R2) residual tumor (HR: 0.15; 95% CI 0.02-0.8; p < 0.05). The SIR was 482 (95% CI 259-775) to 823 (95% CI 442-1322), suggesting a 482-823 times higher risk of developing a breast desmoid tumor after breast augmentation than the general population.
We present a nonrandom association between breast implants and desmoid tumors. Whether the tumors arise from the surgical trauma or the implant's biomaterial is unknown. When surgery is indicated, negative margins reduce the risk of recurrence.
研究表明，植入式乳房隆乳术是乳房纤维瘤的危险因素。这种相关性的统计强度尚不清楚，因为证据仅限于轶事报道。
通过放射学、乳房和肉瘤数据库，确定了 2000 年至 2021 年间在一家中心就诊的患有乳房纤维瘤和乳房植入物病史的患者。计算标准化发病比 (SIR) 以评估乳房纤维瘤与乳房植入物之间的相关性。将这些病例与已发表的病例进行汇总分析。使用 Kaplan-Meier 方法和 Cox 比例风险模型估计无进展生存曲线和风险比。
从一家机构确定了 14 名患者和文献中的 66 例。所有患者均为女性，平均年龄为 38 岁（范围 20-66 岁）。63 例（82%）接受了切除术，9 例（12%）接受了化疗，3 例（4%）接受了索拉非尼治疗，11 例（14%）接受了激素治疗，3 例（4%）接受了主动监测。切除后，2 年无复发生存率为 77%（95%CI 65%-89%）。与显微镜下（R1）或肉眼（R2）残留肿瘤相比，无残留肿瘤（R0）的切除后复发风险较低（HR：0.15；95%CI 0.02-0.8；p<0.05）。SIR 为 482（95%CI 259-775）至 823（95%CI 442-1322），提示乳房隆乳后发生乳房纤维瘤的风险比普通人群高 482-823 倍。
我们提出了乳房植入物与纤维瘤之间存在非随机关联。肿瘤是由手术创伤还是植入物的生物材料引起的尚不清楚。当需要手术时，阴性切缘可降低复发风险。
