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Why do silicone implants cause cancer or fibrous capsule contracture?
Why do silicone implants cause cancer or fibrous capsule contracture? Which is safer? “The world’s richest scientist” conducted a comparative study.
Every year, millions of women around the world undergo silicone breast implant surgery for breast augmentation or breast reconstruction after breast cancer removal surgery. However, this kind of silicone implant is not usable for a lifetime. According to FDA statistics, due to the accumulation of scar tissue and other complications, most silicone implants need to be replaced within 10 years.
Silicone breast implants have been used since the 1960s, and the earliest version has a smooth surface. However, this smooth-surfaced silicone implant causes a complication called fibrous capsule contracture. Scar tissue will form around the silicone implant and squeeze, causing pain and obvious deformation of the implant. It needs to be adjusted or removed surgically.
In the late 1980s, some companies developed silicone implants with a rougher surface, hoping to reduce the incidence of fibrous capsule contracture and make them better “stick” to the tissues and stay in place. However, in 2019, due to the risk of anaplastic large cell lymphoma associated with breast silicone implants, the FDA required breast silicone implant manufacturers to recall all high-texture breast silicone implants marketed in the United States.
On June 21, 2021, the team of Professor Robert Langer of the Massachusetts Institute of Technology published a research paper titled: The surface topography of silicone breast implants mediates the foreign body response in mice, rabbits and humans in the journal Nature Biomedical Engineering, a sub-Journal of Nature. .
The research team systematically analyzed how the different surface structures of breast silicone implants affect adverse reactions, especially high-textured silicone implants that may cause lymphoma in rare cases.
The study showed that the surface morphology of silicone implants will greatly affect the perception of immune response to it. Animal experiments and analysis of tissues around human breast silicone implants collected during repair surgery show that the average roughness is The 4 micron silicone implant caused the least inflammation and foreign body reaction. This research provides a basis for plastic surgeons to evaluate and better choose implants. It can also help scientists design more biocompatible implants in the future.
The research team tested five commercially available silicone implants with different topography (including roughness). Including the previously recalled high-texture silicone implants, completely smooth silicone implants, and three types of silicone implants in between. The surface roughness of these silicone implants is between 0-90 microns.
Next, the research team implanted these silicone implants of different roughness into the mammary fat pads of mice and rabbits. Experimental results show that all silicone implants stimulate T cells in different ways. Silicone implants with rough surfaces stimulate more pro-inflammatory T cell responses, while silicone implants with 4 micron roughness stimulate inhibition T cells that organize inflammation.
The research team found that rougher silicone implants rub the surrounding tissues and cause more irritation, which explains why rougher silicone implants can cause lymphoma: rougher silicone implants rub the surrounding tissues and cause more irritation. It falls off in human tissues and causes chronic inflammation, which may eventually lead to cancer.
After animal experiments, the research team analyzed a large number of cancer tissue samples from MD Anderson Cancer Center to study the response of human patients to different types of silicone breast implants. In these samples, the research team found evidence of the same type of immune response seen in animal studies. They observed that tissue samples from patients with high-texture silicone implants showed signs of chronic, long-term immune responses.
This study provides the first evidence that optimizing the surface structure can minimize inflammation and foreign body reactions. This work will make a significant contribution to the entire medical device industry. The research team also expressed the hope that this research data can help other researchers optimize the design of silicone breast implants and other types of medical silicone implants to improve safety.
The 4 micron roughness silicone implant with the best safety in the study was developed by Establishment Labs, a high-tech medical device and beauty product development company. It was listed on the Nasdaq in 2018 and its current market value is close to 2 billion. US dollars.
The leader of the research is Robert Langer, who is known as “the richest scientist in the world”. He is also a scientific consultant for Establishment Labs.
Robert Langer is a professor at the Massachusetts Institute of Technology. His paper has an H index of 232, making him the engineer with the highest H index in history. He has more than 1,130 issued and pending patents, which have been licensed or sublicensed to more than 300 companies.
He is one of the few members of the National Academy of Medical Sciences, the National Academy of Engineering, the National Academy of Sciences, and the National Academy of Inventors to be elected to the National Academy of Inventors at the same time. He is also one of four living persons who have won both the U.S. National Medal of Science and the U.S. National Medal of Technology and Innovation.
In addition to these achievements and honors in the field of science and technology, he has also participated in the creation of more than 40 technology companies. Recently, Moderna Therapeutics, which has been popular all over the world for the COVID-19 mRNA vaccine, was established and developed under his impetus. Today, Moderna’s market value is as high as 83.6 billion U.S. dollars.
(source:internet, reference only)