Breast Implant Illness and Autoimmune/Inflammatory Syndrome Induced by Adjuvants: Mechanistic Rationale and a...

Area of Science:

• Immunology
• Toxicology
• Biomaterials Science

Background:

• Breast implant illness (BII) is characterized by diverse systemic symptoms in patients with breast implants.
• Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) offers a framework for understanding biomaterial-induced immune responses.
• The causal link between breast implants and these conditions remains under investigation, lacking validated diagnostic markers.

Purpose of the Study:

• To review current evidence on BII and implant-related ASIA.
• To explore epidemiological data, clinical presentations, and biological plausibility.
• To propose a diagnostic and management algorithm for BII/ASIA-like presentations.

Main Methods:

• Narrative review of existing literature on BII and ASIA.
• Analysis of proposed biological mechanisms, including inflammation and immune activation.
• Distinguishing BII/ASIA from implant-associated malignancies like ALCL.

Main Results:

• Multiple proposed mechanisms link implants to systemic symptoms, including chronic inflammation, material leaching, and immune dysregulation.
• No definitive diagnostic biomarker for BII or implant-related ASIA currently exists.
• Explantation outcomes and implant-associated complications are discussed in the context of patient management.

Conclusions:

• A multidisciplinary approach is recommended for diagnosing and managing patients with BII/ASIA-like symptoms.
• Structured assessment, exclusion of other conditions, and patient counseling are crucial.
• Individualized decision-making regarding medical management and explantation is advised.