The First Reported Case of Hemoptysis After Silicone Gel Breast Implants

Background: Hemoptysis after silicone breast prosthesis surgery has not been reported so far, and the mechanism is unclear. Case presentation: A 25-year-old young woman presented hemoptysis after silicone breast prosthesis replacement surgery. CTA revealed diffuse interstitial, alveolar, and terminal bronchial exudate changes in absent of pulmonary embolism. Noninvasive ventilator assisted breathing, combined with atomized inhalation of budesonide 2ml every 8h and intravenous infusion of hydrocortisone 100mg every 12h. Chest CT improved significantly 3 days later, and discharged 10 days later. Conclusions: Diffuse alveolar hemorrhage might be the cause of hemoptysis after silicone breast augmentation, and glucocorticoid treatment is very effective. However, if pulmonary imaging suggested diffuse pulmonary hemorrhage, BAL and lung biopsy should be performed to confirm the clinical diagnosis before treatment.

Autoinflammatory/Autoimmunity Syndrome Induced By Adjuvants (ASIA) Due to Silicone Incompatibility Syndrome

The adjuvant-induced autoimmune syndrome (ASIA) is associated with a dysregulation of the innate and adaptive immune system after exposure to chemical compounds, including liquid paraffin, silicone gel, acrylamides, and hyaluronic acid. Due the increase of the use of these compounds in cosmetic procedures, the prevalence of this syndrome is increasing. We present the first report in Ecuador associated to ASIA after an elective silicone breast prosthesis procedure, manifested as polyarthralgia, positive antinuclear antibody, anticentromere antibody, and a moderate positive Sclero-70.

External Breast Prosthesis for Post Mastectomy Women

Women who have had a mastectomy for breast cancer have to cope with two major problems: first, that they have cancer, and second, that they have lost their physical appearance. The provision of an appropriate prosthesis breast forms, have an opportunity to choose between then, and to be satisfied with their choice. After mastectomy, the provision of an appropriate breast prosthesis help to improve body image and quality of life and reduce associated emotional distress.

Influence of the breast prosthesis volume in dose distribution in radiotherapy planning

Introduction: The challenge of modern radiotherapy (RT) in breast cancer is to maintain its satisfactory oncological results, adapting to oncoplastic surgery and avoiding possible cosmetic damage. Considering that the breast prosthesis is not a target volume in RT planning, this study sought to analyze the effect of this volume on the coverage of the clinical target volume (CTV) of the breast. Methods: We performed a retrospective analysis of plans in 48 patients who submitted to RT in the first half of 2014. Two volumes were measured, such as breast CTV (breast tissue with the prosthesis) and real CTV (breast tissue excluding the prosthesis). The D95% values (dose that covers 95% of the volume) for each of them were verified and related to the volume of each one as well as the volume of breast prosthesis. Results: The analysis of the CTVs showed a significant difference between the mean volumes for the real CTV and breast CTV. While performing the CTV coverage, including the prosthesis, there is a perception that the dose covered 95% of the volume. Nevertheless, the analysis of the same plan after prosthesis volume exclusion revealed a difficulty in covering 95% of the breast tissue volume, indicating the interference of the prosthesis in therapy planning. Considering the dosimetric aspects, there were patients with real CTV values below the ideal dose of 47.5 Gy, after exclusion of implant volume. Conclusions: Our data reflected the volume of the prosthesis as an important variable that should be considered when planning adjuvant RT.