Association of Silicone Breast Implants, Breast Cancer and Anti-RNA Polymerase III Autoantibodies in Systemic Sclerosis: Case-Based Review

Rossella De Angelis, Jacopo Di Battista, Gianluca Smerilli, Edoardo Cipolletta, Marco Di Carlo, Fausto Salaffi Rheumatology Clinic, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Jesi, Ancona, ItalyCorrespondence: Rossella De AngelisRheumatology Clinic, “Carlo Urbani” Hospital, Jesi, Ancona 60035, ItalyEmail r.deangelis@staff.univpm.itAbstract: Some case reports and small case series of patients with silicone breast implant (SBI) have reported the development of systemic sclerosis (SSc) many years later, despite conflicting evidence of this association in the literature. Recently, patients with SSc and anti-RNA polymerase III antibodies positivity have been associated with previous silicone implants and/or breast cancer, showing clinical features that differ from the classic SSc, such as rapid and diffuse cutaneous involvement and scleroderma renal crisis (SRC). The specific autoimmune reaction is not yet fully understood, although knowledge in this regard is increasing. We describe a case that can support these previous observations, strengthening this association which must be taken into account. Clinicians should be aware of this new clinical entity, given the widespread use of silicone implants.Keywords: systemic sclerosis, silicone breast implant, anti-RNA polymerase III antibodies, cancer