Rupture of Breast Implants Does Not Cause Systemic or Local Immune Changes

Breast implant rupture occurs in both saline and silicone implants, with estimated risk of rupture between 5.3% and 15.1% over a 10-year period. Concerns regarding the effect of breast implants on the immune system remain despite currently published data that does not support a link between implants, ruptured or not, and autoimmune symptoms. The authors aimed to determine if there were systemic or local immune changes caused by implant rupture. Healthy females with either ruptured or intact breast implants were recruited. Enzyme-linked immunosorbent assay (ELISA) was performed to examine systemic levels of 6 antibodies against breast-related antigens. Bulk RNA-sequencing of breast tissue adjacent to the implant was analyzed to identify differentially expressed genes (DEGs). Sixty-seven females were assessed with ELISA. Of those, 24% (16/67) had ruptured breast implants and 76% (51/67) had intact implants. There were no differences in antibody levels between intact and ruptured implants. Subgroup analyses of ruptured implants revealed no differences in antibody levels between ruptured saline and silicone implants, submuscular and subglandular implants, or textured and smooth implants. Bulk RNA-sequencing of breast tissue adjacent to ruptured implants (n = 5) and intact implants (n = 5) was performed. This revealed only 1 immune-related DEG (MS4A1), which was a downregulated gene related to B cell activation and differentiation. Rupture of breast implants was not associated with systemic changes in antibody levels or local changes in gene expression of breast parenchyma. There was no evidence for immune-related changes that might explain the autoimmune-like clinical symptoms some patients experience after implant rupture. Level of Evidence: 3 (Therapeutic).