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

PURPOSE: 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. Patients with ruptured breast implants may express concern about the inflammatory response to rupture and some present with autoimmune-like symptoms such as pain, inflammation, fatigue, and arthralgias. The authors aimed to determine if there were local or systemic immune changes caused by implant rupture. METHODS: Healthy women ages 18 to 80 with either ruptured or intact breast implants were recruited between 2018 and 2022. Enzyme linked immunosorbent assay (ELISA) was used to examine systemic levels of 5 antibodies against breast-related antigens, which included carcinoembryoantigen (CEA), mucin-1 (MUC-1), estrogen receptor-α (ER), and human epidermal growth factor receptor 2 (HER-2), mammaglobin-A. Bulk RNA-sequencing of breast tissue adjacent to the implant was analyzed for over 28,000 genomic markers to identify any differentially expressed genes (DEGs). RESULTS: Sixty-seven women were assessed with ELISA. Of those, 24% (16/67) had ruptured breast implants and 76% (51/67) had intact implants. There were no significant differences in any of the measured 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-seq of breast tissue adjacent to ruptured implants (n=5) and intact implants (n=5) was performed. This revealed only 1 immune system-related DEG (MS4A1), which was a downregulated gene related to B cell activation and differentiation. CONCLUSION: 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 may explain the autoimmune-like clinical symptoms some patients experience after implant rupture.