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Cancer Cell Sanctuary in Breast Implant Capsule: a Case Report and a Review of Literature

Michelle Lee MD, Devra Becker MD
Case Western Reserve University Department of Plastic and Reconstructive Surgery
2012-01-30

Presenter: Michelle Lee

Affidavit:
100% of the work is the original work of the resident and the senior author.

Director Name: Arun Gosain

Author Category: Chief Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)

How does this presentation meet the established conference educational objectives?
1. Conference participants will be aware of breast capsule serving as a cancer cell sanctuary.

How will your presentation be used by practicing physicians in the audience?
1. The practicing physician will be able to better manage cancer patients with breast implants.

Since the 2011 Food and Drug Administration press release announcing a possible association between anaplastic large cell lymphoma and breast implants, increasing attention has been paid to reports of cancer and breast implants. We present a case where cancer cells were found in the peri-prosthetic fluid of a patient with Hodgkin's lymphoma treated with chemotherapy and radiation. The patient is a 48 year-old female who had breast augmentation with bilateral saline implants in 2002. She was subsequently diagnosed with stage IA Hodgkin lymphoma nodular sclerosing type in 2010. After treatment with two cycles of ABVD and radiation, the lymphoma was in remission with no signs of recurrence. However, an increasing size of her left peri-prosthetic fluid collection was noted on follow up CT scan. Drainage of the fluid collection demonstrated Reed-Sternberg cells consistent with Hodgkin's lymphoma. To our knowledge, this is the first published report where a patient had successful Hodgkin's lymphoma treatment and experienced cancer recurrence exclusively in the breast capsule. This suggests that the breast capsule served as a sanctuary for cancer cells. The current report will review the literature regarding recurrent cancer in the breast capsule and discuss possible interventions as well as preventions.

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