Non-Breast Implantable Medical Devices and Associated Malignancies: A Systematic Review

Natalia Ziolkowski; John Milkovich; Alexandra D'Souza; Ryan E Austin; Patricia McGuire; Frank Lista; Jamil Ahmad

doi:10.1093/asj/sjae178

Non-Breast Implantable Medical Devices and Associated Malignancies: A Systematic Review

Aesthet Surg J. 2024 Aug 8:sjae178. doi: 10.1093/asj/sjae178. Online ahead of print.

Authors

Natalia Ziolkowski¹, John Milkovich², Alexandra D'Souza², Ryan E Austin³, Patricia McGuire⁴, Frank Lista³, Jamil Ahmad³

Affiliations

¹ Division of Plastic and Reconstructive Surgery, McMaster University, Hamilton, ON, Canada.
² Mr Milkovich and Ms D'Souza are medical students, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
³ Plastic surgeons in private practice, Mississauga, ON, Canada.
⁴ Plastic surgeon in private practice, St. Louis, MO, USA.

PMID: 39116371
DOI: 10.1093/asj/sjae178

Abstract

Innovation in healthcare has led to the development of numerous implantable medical devices (IMDs). However, advances in our knowledge of breast implant-associated malignancies have raised questions about the prevalence, etiology and management of malignancies associated with non-breast IMDs. The objective of this study was to examine the prevalence and characteristics of malignancies associated with non-breast IMDs. An expert medical librarian developed the search strategy for this review. Databases included MEDLINE (National Library of Medicine, Bethesda, MD; date range of search: 1946 to June 21, 2023), EMBASE (Elsevier, Amsterdam, the Netherlands; date range of search: 1946 to June 21, 2023), and Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane Library, Wiley, Hoboken, NJ; date range of search: 1946 to June 21, 2023). In addition, grey literature sources were searched and relevant references from systematic reviews and meta-analyses were included. The PRISMA guideline was used to guide the review. Risk of bias was evaluated using the JBI Critical Appraisal tools. A total of 12,230 articles were reviewed with a total of 77 meeting inclusion criteria. Risk of bias was highest with case reports (moderate, average of 65.1% with range of 37.5 to 100%) and low for the remaining study types. In total, 616 cases of IMD-associated malignancies were identified. Malignancies associated with IMDs were reported in the head/neck (543, 88.1%), lower extremity (57, 9.6%), thorax (9, 1.4%), abdomen (3, 0.5%), and genitourinary system (2, 0.3%). The most common malignancy type in the lower extremity was sarcoma, in the head and neck was squamous cell carcinoma, and in the thorax was lymphoma. This study is the first comprehensive systematic review of its kind. Overall, the oncologic risk of IMDs is low. The discussion of malignancy is an important part to the overall consent process and malignancy should be considered with any new signs or symptoms in the anatomic area of an implant. More data is needed to better understand how primary malignancies occur around IMDs and how to reduce this risk.

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