THE VOICE OF SILENCE: WHEN SCIENCE IS THE ENEMY. THE BREAST IMPLANT ILLNESS JOURNEY I would like to present my book on silicone implants. I decided to publish it due to the recent recommendations promoted by the FDA regarding implant complications.
In the book, I recount how my battle was over these four years studying the topic, from noticing changes in patients to FDA validation of silicone disease.
I show the whole trajectory, full of controversies and discussions. Availab
We are pleased to participate in the EUROFOARMA initiative, which created the euro award to reward Brazilian health innovation initiatives. We leave here the voting link for Brazilian doctors who are interested in the initiative. We live in challenging times in global health due to the pandemic of COVID 19. We believe that all energies should be focused on controlling this disease. We sympathize with all the patients and family members who are suffering from this disease. It
Two years ago, I attended a conference in São Paulo, Brazil, regarding breast cancer oncoplastic surgery. One of the speakers, a breast surgeon, presented a case of a woman with terminal breast cancer. He argued that that woman, with six months of life expectative, has the right to go to an oncoplastic reconstruction to have a dignified death. I was thinking that time, what are the values of modernity: aesthetic results or spiritual fullness? There is not a binary answer to t
Regarding breast implants, much attention is focused on texture and the relationship with complications. Most studies show that there is a higher chance of complications in textured implants, notably macro textured implants. Some facts are relevant in this matter and should discuss: – Textured implants are more used than smooth ones; – Textured implants, many of them, also have a smooth surface in their composition. We show an image of a patient with seroma in the right breas
I would like to share my experience with some women suffering from BII. I have contacted many. I found it interesting to share the story of a special person who will keep her identity anonymous but who I think may contribute to the debate on BII and BIA-ALCL. She was diagnosed with BIA-ALCL after 10 years of breast implants. Formerly healthy, she reports several immunological manifestations after implant placement. It culminated in the diagnosis of BIA-ALCL and implant remova
“Female empowerment, digital transformation, leadership, democratization of knowledge and access to information, digital immediacy, medicine 4.0, …” Increasingly these words are present in our daily lives and will clearly change the patient-doctor relationship. I am convinced for better. Through social networks, women today are able to organize for the common good with speed and efficiency. Discuss their afflictions, report their experiences, exchange information became part
Undoubtedly without inspiration in the manuscripts published by Prof. Jan Willem Cohen Tervaert our research would not have evolved. The various papers reporting the ASIA syndromes (autoimmune/ inflammatory syndrome induced by adjuvant) and SIIS (silicone implant incompatibility syndrome) were a source of inspiration for our research since our patients had clinical symptoms similar to those described by Prof. Tervaert. When we saw the presence of free silicone in the first co
Over the course of the study, we observed that SIGBIC was often associated with intracapsular collection in magnetic resonance imaging scans. Many MRI protocols do not use contrast media for implant evaluation, which limits the diagnosis of SIGBIC. We began conducting directed ultrasound studies on patients with intracapsular collection.
In these patients it was possible to observe associated findings to the intracapsular collection: echotexture changes of the breast implants
Before beginning our prospective study we spent a period looking at what were the common findings on MRI related to breast implants. We describe 3 original findings that were related to SIGBIC: T2 * hypersignal mass, late contrast enhancement mass, and black drop signal.
With the prospective study initiated, we observed in our initial results high specificity of these findings in the diagnosis when present together. All cases in which SIGBIC was suspected, the diagnosis was c
This 2018 article by Fleming et al reoijts 2 cases of spontaneous BIA-ALCL remission between diagnosis and surgical time. Interestingly, in the histological slides free silicone corpuscles are observed in case 2. It is noteworthy that silicone bleeding is a factor ignored in the literature as a possible cause of BIA-ALCL.
The postoperative findings of the implant fibrous capsule are very similar to those reported in our studies. https://www.ncbi.nlm.nih.gov/pubmed/29445921 Es
This may be the main article related to SIGBIC, where we illustrate how the diagnosis should be made and how to correlate the histology with the imaging findings. We divided the SIGBIC into 3 types, ranging from more indolent to more aggressive. The findings and descriptors are original to this study. https://www.hindawi.com/journals/jir/2018/6784971/ Este talvez seja o principal artigo relacionado ao SIGBIC. Nele demonstramos como deve ser realizado o diagnóstico e correlaci
In 2014, Taylor et al reported the color change of breast implants after explantation. Described how it changed in color from clear to cloudy. It raises the possibility of a chemical reaction being responsible for this reaction. As there is this chemical reaction, residual products get in contact to the fibrous capsule.
These findings are found in almost all patients diagnosed with SIGBIC undergoing surgery, corroborating the hypothesis that gel bleeding is a causal factor of
In a 2016 study analyzing the autopsy of 2 women who had breast implants, Kappel et al concluded that silicone particles were present in all organs, including the central nervous system. The patients had symptoms similar to BII. Attached the link of the study: https://clinmedjournals.org/articles/cmrcr/clinical-medical-reviews-and-case-reports-cmrcr-3-087.pdf Em estudo de 2016, analisando a autópsia de 2 mulheres que tinham implantes mamários, Kappel est al concluiram que o s
The SIGBIC blog story. Silicone Induced Granuloma of Breast Implant Capsule The purpose of creating this blog was due to the increasingly presence of breast implants complaints in our clinical practice. We observed that many of the symptoms reported by our patients, such as joint pain, breast hardening and inflammation, itching, breast enlargement, and skin changes were similar to those reported by women regarding Breast Implant Illness (BII). These women with BII organized t
The first case of SIGBIC described in our service was in 2017. It motivated the first publication on the subject. Previously, we had presented a case of BIA-ALCL with the imaging findings which motivated us to start a study on the subject. When we came across a case that had clinical symptoms and imaging findings similar to the first one, we hypothesized BIA-ALCL as the main differential diagnosis. However the biopsy result was negative for BIA-ALCL, reporting only fibrosis.
Recently, some organized women with breast implants had the initiative to create groups through social media to report symptoms related to breast implants. Several groups were created where patients report complaints related to breast implants. FACEBOOK is one of the chosen platforms where there are groups with up to 90,000 women. This should not be ignored by the scientific community. Currently, some media plataforms are beginning to reverberate the reports of these groups,