de Faria Castro Fleury Eduardo
Department of Radiology, Centro Universitário São Camilo-Curso de Medicina, São Paulo, Brazil.
IBCC Oncologia, São Paulo, Brazil.
Front Surg. 2023 Sep 12;10:1249078. doi: 10.3389/fsurg.2023.1249078. eCollection 2023.
Many complications related to silicone implants have been reported recently, from clinical symptoms manifestations to association with some specific types of cancer. During the early 2010s, it was believed that implants were biocompatible and inert to the human body and that gel bleeding/leakage events were rare and without repercussions for the human body. However, at the end of 2010s, several studies pointed out that gel bleeding was more frequent than previously believed, and the pathogenic potential of free silicone should not be ignored. The Food and Drug Administration recommends performing magnetic resonance imaging in asymptomatic patients 5-6 years after implant placement. The descriptors in the Breast Imaging and Reporting Data System lexicon seem outdated for classifying the new generations of implants with cohesive gel, which hinders the diagnosis of device complications. In this review, supported by our research data publications related to silicone implants for 6 years on a prospective study protocol, most of them being original articles, we summarized the main complications observed in clinical practice and discuss the impact of these changes on patients' outcomes focusing on the pericapsular space.
最近报道了许多与硅酮植入物相关的并发症，从临床症状表现到与某些特定类型癌症的关联。在21世纪10年代初，人们认为植入物具有生物相容性且对人体无活性，凝胶渗出/渗漏事件很少见且对人体没有影响。然而，在21世纪10年代末，几项研究指出凝胶渗出比之前认为的更频繁，游离硅酮的致病潜力不应被忽视。美国食品药品监督管理局建议在植入物放置5至6年后对无症状患者进行磁共振成像检查。乳腺影像报告和数据系统词汇表中的描述符对于分类新一代具有粘性凝胶的植入物似乎过时了，这妨碍了对器械并发症的诊断。在本综述中，在我们关于硅酮植入物的6年前瞻性研究方案的研究数据出版物（其中大多数为原创文章）的支持下，我们总结了临床实践中观察到的主要并发症，并聚焦于包膜周围间隙讨论了这些变化对患者预后的影响。
