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To the Editor: In a case-control study, Dr de Jong and colleagues¹ reported a possible association between silicone breast implants and anaplastic large T-cell lymphoma (ALCL). Although histological material of breast lymphomas was retrieved and additional immunohistochemistry and molecular studies were performed, the authors did not report on the presence of foreign bodies and foreign body reactions adjacent to the breast lymphomas. Apart from leakage and rupture, silicone gel can migrate through the intact silicone elastomer shell, a process that is called bleeding.²

Light microscopy, the technique used in the study by de Jong et al, may reveal migrated silicone particles as foreign inclusions in capsular tissue and lymph nodes.³ However, this technique lacks the specificity to differentiate silicone-containing inclusions from other foreign body material. Confocal laser-Raman microprobe identification is a technique that can accurately determine the presence and chemical composition of silicone gel inclusions in human breast tissue . . . [Full Text of this Article]

Astrid A. M. van der Veldt, MD
aam.vanderveldt@vumc.nl

Sebastiaan A. Kleijn, MD; Prabath W. Nanayakkara, MD, PhD
Department of Internal Medicine
VU University Medical Center
Amsterdam, the Netherlands

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