The peri-implant breast capsule: An immunophenotypic study of capsules taken at explantation surgery

Silicone-based breast implants continue to be the focus of many studies att empting to correlate implant failure to clinical and pathological factors. Routine pathology of periimplant capsule is extensively described in the li terature. The actual significance of the cellular events remains unconfirme d, particularly with reference to clinical outcome. This study reviews our experience with explanted capsules. The study makes specific reference to t he immunohistochemistry of the tells participating, in the capsule and the significance of the immunophenotypic characterization of these cells to cli nical outcome. The use of a wide selection of immunomarkers for T and B lym phocytes and histiocytes provided no supporting evidence for local cell par ticipation in the capsule, which may indicate the presence of an immunologi cal reaction present in the capsule at the time of explantation. One was on ly able to confirm the presence of a low grade inflammatory process and pro gression to fibrosis and calcification over time. Statistical correlation w as obtained only between Baker grade of capsular contracture and CD3/CD68 i mmunomarker positivity, CD45RO did show correlation with pain. No correlati on was demonstrated with calcification. The results obtained in this study highlighted the need for further investigations into the mechanism of histi ocyte and fibrocyte recruitment and activation in the capsule, a possible s ource of pain and contracture, which is a serious long-term clinical findin g leading to the necessity for explantation. (C) 2000 John Wiley & Sons. In c.