SP38. The Impact of Implant Shells on the Survival of Breast Cancer Cells: A Novel Study

PURPOSE: Breast implant safety has become a particularly scrutinized topic within reconstructive surgery. Alongside concerns of breast-implant associated anaplastic large cell lymphoma, similar inquiries into whether breast implants are associated with breast cancer recurrence have been made. Although a prior cohort study found that the use of textured implants was associated with the recurrence of breast cancer, most other clinical data demonstrates that breast implants are not associated with higher rates of breast cancer either primary of recurrent. Our in vitro study sought to better delineate and understand the interactions between silicone breast implant shells and triple negative breast cancer (TNBC) cells. METHODS: MDA-MB-231 TNBC cells and HFF-1 human foreskin fibroblast cells were cultured in media containing 10% fetal bovine serum and 1% penicillin/streptomycin. Pro-angiogenic genetically modified via adenovirus transfection E4 endothelial cells were cultured in media containing 10% endothelial cell supplement. Silicone-based textured and smooth implant shells were shaped to line 96-well plates, but did not line the bottom of the well. Wells with no implants served as a control. Cells were plated at 1,000 cells/well. Cell morphology was imaged over 10 days and cell numbers were quantified per image frame at 100x magnification with ImageJ. RESULTS: TNBC cells in no implant comparison wells showed significant increases in normalized cell number by 14.45 fold (p<0.0001) over 10 days that was greater than that of smooth implant wells at 4.43 fold (p = 0.0018); TNBC cells in textured-lined wells did not display a significant change in normalized cell number at 1.42 fold increase. Fibroblasts in no implant comparison wells demonstrated a significant 7.96 fold increase (p<0.0001) in normalized cell number that was greater than that of smooth implant wells at 2.55 fold (p = 0.0009); fibroblasts in textured implant wells demonstrated a significant decrease in cell number by 4.4 fold (p<0.0001). E4 cells in no implant comparison groups demonstrated a 13.88 fold increase in cell number (p<0.001); E4 cells in smooth and textured implant lined wells demonstrated decreases in cell number by 2.50 (p = 0.0193) and 5.50 (p>0.05) fold respectively. Morphological changes including cytologic swelling were noted among all cell lines in implant-lined wells. CONCLUSIONS: This study is the first to culture TNBC in exposure to silicone breast implant shells. These results demonstrate that TNBC cell numbers were decreased when exposed in culture to either smooth or textured implants relative to wells containing no implants. Similar trends are seen in cells of endothelial and connective tissue lineages. In the context of conflicting research documenting the association of breast cancer in the pres