Silicon tissue assay: a measurement of capsular levels from chemotherapeutic port-a-catheter devices.
A plethora of data has been used to condemn and defend the role of silicone and its association with "adjuvant disease." In the ongoing attempt to enhance our knowledge, we have chosen to identify tissue silicon levels (n = 15) in capsules that form around chemotherapeutic port-a-catheter devices, which consist of a metal dome encapsuled by silicone. We have compared these levels with previously established silicon levels in augmented breast capsules, distant tissue sites in these same augmented women, and nonaugmented cadaveric tissues from various geographic locations in the United States. All specimens were harvested by a "no touch" technique, not formalin fixed, frozen, and shipped to an independent toxicology laboratory for analysis. Inductively coupled plasma atomic emission spectroscopy was employed to obtain the tissue silicon measurements. Results demonstrated silicon values ranging from nondetectable in 9 patients to as high as 41 micrograms/gm. These values fell in between our cadaveric (0.5 to 6.8 micrograms/gm) and augmented tissue silicon levels (18 to 8700 micrograms/gm). Although the sample size is small and the power of statistical analysis is low, there was no correlation between the patient's silicon level and age, type of cancer, type of chemotherapeutic agent, radiation therapy, or length of time the port-a-catheters were in place. Although detectable levels of silicon identified around port-a-catheter devices were higher than expected, it is impossible to make any conclusions about these levels and the role of a potential collagen-vascular disease. What we have shown, however, is that silicone breast implants may not be the only medical device that can elevate tissue silicon levels. Our data seem to suggest that there may be a progression of measurable tissue silicon levels based on the amount of environmental or device-related silicon exposure a person has had at a particular time in his or her life. It is our belief that as we identify these tissue silicon levels, they will serve as a baseline and reference for further scientific studies.
Evans
G R
GR
Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Houston, USA.
Baldwin
B J
BJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000497:Alloys; D001940:Breast / Q000737:chemistry; D018427:Breast Implants; D002102:Cadaver; D002408:Catheters, Indwelling; D002648:Child; D002675:Child, Preschool; D003095:Collagen Diseases / Q000209:etiology; D003238:Connective Tissue / Q000737:chemistry; D004867:Equipment Design; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D018401:Sample Size; D012825:Silicon / Q000032:analysis*; D012828:Silicones; D013057:Spectrum Analysis; D013997:Time Factors; D014018:Tissue Distribution; D014652:Vascular Diseases / Q000209:etiology
D000497:Alloys; D012828:Silicones; D012825:Silicon