Breast Textured Implants Determine Early T-helper Impairment: BIAL2.20 Study

Anticancer Res. 2021 Apr;41(4):2123-2132. doi: 10.21873/anticanres.14984.


Background/aim: Surgical stress has been correlated with higher rate of postoperative complications. Breast implants' surfaces (textured or smooth) represent an immunological stimulus. Our prospective study (BIAL2.20) evaluated post-operative leukocytes response at baseline and postoperative day (POD) 1 and 2 after implant-based breast reconstruction.

Patients and methods: Between January and July 2020, 41 patients underwent reconstruction with textured (n=23) or smooth (n=18) implants. A full blood count and lymphocyte subsets were collected before surgery, on POD1 and POD2. Data were evaluated as difference and relative difference from baseline by two-way analysis of variance test (2-way-ANOVA). Mann-Whitney U-test was performed at each POD, whenever between-group 2-way-ANOVA reached statistical significance.

Results: Within-group-analysis showed statistically significant total leukocytosis in both groups. Within-group-analysis of lymphocytes subsets demonstrated statistically significant lymphopenia in the textured group for T-lymphocytes, and T-helper cells. Between-group-analysis showed statistically significant lymphopenia in T-helper subsets in the textured group at POD1 and POD2, when compared with the smooth group.

Conclusion: Textured implants demonstrated a statistically significant impairment of T-helper trend during POD1 and POD2 when compared to smooth implants by between-group 2-way-ANOVA.

Keywords: Breast cancer; Macrotextured implant; breast implant; breast reconstruction; immune function; immunological; leukocytes; lymphocytes; surgery; white blood cell.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Breast Implantation* / adverse effects
  • Breast Implantation* / instrumentation
  • Breast Implantation* / methods
  • Breast Implants / adverse effects*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery
  • Equipment Design / adverse effects
  • Female
  • Humans
  • Lymphopenia / diagnosis
  • Lymphopenia / etiology*
  • Lymphopenia / immunology
  • Mammaplasty* / adverse effects
  • Mammaplasty* / instrumentation
  • Mammaplasty* / methods
  • Mastectomy / methods
  • Middle Aged
  • Postoperative Complications / diagnosis
  • Postoperative Complications / immunology*
  • Postoperative Complications / pathology
  • Postoperative Period
  • Prospective Studies
  • T-Lymphocytes, Helper-Inducer / pathology*
  • Time Factors