[Breast implant-associated squamous cell carcinoma]

Numerous clinical studies and experimental findings have confirmed that breast implants with different textures and fillings can promote structural changes in cells and tissues within the implant capsule, which may induce tumorigenesis in the long term. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and squamous cell carcinoma (BIA-SCC) are two distinct malignant conditions that develop within the implant capsule and are clearly distinct from breast cancer; their estimated incidence and prevalence are low. Recognized by the WHO since 2023, BIA-SCC is an immunological inflammatory process associated with chronic antigen stimulation, where the actual risk of tumor development and its triggering factors remain unclear, but the investigation of tumor-associated genetic mutations and environmental influences remains at the center of scientific interest. Systemic symptoms of immunodeficiency (fever, chronic fatigue, weakness) are less prominent in the presence of CK5/6 and p40/p63 positivity. Local symptoms (late seroma, painful breast swelling, asymmetry, capsule thickening, skin symptoms) dominate and typically appear 15-20 years after implantation. Positive cytology and immunohistochemistry results following imaging studies (ultrasound, MRI, fine-needle aspiration biopsy, CT, PET/CT) indicate a good prognosis in localized cases. In 80% of patients diagnosed with BIA-SCC, extracapsular tumor invasion is already evident at the time of diagnosis. The aggressiveness of BIA-SCC is demonstrated by the fact that the 6-month mortality rate in registered cases was very high, at 43.8%. Care must be provided with mandatory multidisciplinary professional involvement, and data recording is mandatory in every country; in Hungary, there is a reporting obligation to the Implant Registry of the National Health Insurance Fund Administration. Beyond plastic surgery and oncology research, all physicians must be aware of the importance of monitoring the signs and symptoms of patients with breast implants and, in cases of clinical suspicion, referring patients for appropriate diagnostic testing. This study summarizes our current knowledge regarding the epidemiological factors of BIA-SCC, its pathogenesis, genetic and clinical aspects, treatment, and prognosis. Orv Hetil. 2026; 167(40): 1585-1592.