Do silicone breast implants have an impact on multiple myeloma? This has been a question across many decades. The research began in 1962 when researchers Potter and Boyce showed that some products (like mineral oil) could cause chronic inflammation and potentially plasmacytomas. The group went on to inject silicone gel into mice to cause plasmacytomas. Some cases of myeloma in younger women have occurred in women with silicone implants.
This research prompted the initiation of new work in 1996 in the creation of a National Cancer Institute Silicone Implant Multiple Myeloma registry with UAMS researchers to identify whether there was a connection between silicone implants and MGUS, plasmacytomas and myeloma. As of the date of the study readout, eighteen patients had been identified. The researchers concluded at that time:
These data suggest a possible excess risk among women aged less than 45 years~ warranting further investigation. Further work will be needed to verify diagnoses as well as attempt to increase case-finding as the Registry continues to collect cases. More precise estimates of the at-risk population may indicate an excess risk for multiple myeloma among silicone-implanted women, but such an association is as yet unproven.
In 2001, a study was performed to see if breast implant recipients were more likely to develop monoclonal gammopathy of undetermined significance (MGUS). In a study of 288 women with breast implants compared to 288 women without implants, there were 5 MGUS patients in the implant group compared to 4 in the non-implant group. The authors concluded that there was "little evidence to support a substantial increased risk of MGUS in women exposed to breast implants" and that larger studies were needed.
In a more recent individual case study by Dr. James Berenson studied a A 52-year-old African-American woman with a prior history of monoclonal gammopathy of undetermined significance (MGUS) who developed breast cancer in her left breast. After a masectomy on that side, she had reconstruction surgery with a silicone gel breast implant. Three years later, her MGUS had progressed to active multiple myeloma (MM).
According to the case report:
She had a minimal response after two different regimens of bortezomib-based treatments and monthly zoledronic acid, and was placed on maintenance therapy with bortezomib, intravenous dexamethasone, and oral methylprednisolone, as well as ongoing monthly zoledronic acid. After 1 year of this maintenance therapy, during which her myeloma markers remained unchanged, she had her silicone implant replaced with saline. Despite no change in her myeloma treatment, her laboratory values began to steadily improve following removal of the silicone implant. Her M-protein decreased from 2.14 to 0.83 g/dL and her IgG levels from 3,330 to 1,210 mg/dL following replacement of her silicone implant with saline.
This is the first report showing an improvement in clinical myeloma lab values where the removal of silicone implants improved the status of a myeloma patient where otherwise, the lab values were constant.