Asia Syndrome and Breast Implants, Report of A Case and Review of The Literature

Abstract

Background: Over the past decades, evidence has accumulated that autoimmune symptoms can be triggered by exposure to environmental immunostimulatory factors that act as adjuvants in genetically susceptible individuals, with several unexplained symptoms. Adjuvant-induced autoimmune/autoinflammatory Syndrome (ASIA) was described in 2011 by Shoenfeld and Agmon-Levin and defined the diagnostic criteria. However, the association of this syndrome with silicone breast implants is controversial. Objective: To describe a case of ASIA syndrome in a silicone breast implant carrier and review of the literature. Clinical Case: JKT 36-year-old woman with luminal infiltrating ductal carcinoma; with negative extension studies, a conservative mastectomy of the skin and areola was performed with immediate reconstruction with an implant with a breast prosthesis and hormone therapy; Her follow-up was torpid with fatigue, pain in the arm, depression and sleep disturbances and affected breast skin, without infection. As she did not respond to conservative management, it was decided to remove the prosthesis, resection of the capsule and skin, due to the suspicion of the syndrome. From ASIA, as there was no involvement or persistence of breast cancer, with immediate improvement. Method: Bibliographic review of original articles written in English on cases of ASIA syndromes, associated with silicone breast implants from their description to the present. Results: Until 2019, 126 cases of ASIA syndrome due to silicone breast prostheses and implants were reported. Removal of the prosthesis improves symptoms. Conclusion: ASIA syndrome is recent, it is still considered an evolving concept, it is necessary to identify risk factors for the development of autoimmune phenomena in individuals who will receive some type of adjuvant to prevent cases of this syndrome.