title: Oestrogen receptor-alpha and -beta expression in breast implant capsules: experimental findings and clinical correlates.
abstract: Myofibroblasts provide a force to decrease the surface area of breast implant capsules as the collagen matrix matures. 17-β-Oestradiol promotes myofibroblast differentiation and contraction. The aim of the study was to investigate the expression of oestrogen receptors α and β in capsular tissue. The study enrolled 70 women (80 capsules) who underwent expander or implant removal, following breast reconstruction. Specimens were stained with haematoxylin/eosin, Masson trichrome and immunohistochemistry and immunofluorescence stainings for alpha-smooth muscle actin (α-SMA), oestrogen receptor-alpha (ER-α) and oestrogen receptor-beta (ER-β). The relationship between anti-oestrogenic therapy and capsular severity was evaluated. A retrospective analysis of 233 cases of breast reconstruction was conducted. Myofibroblasts expressed ER-α, ER-β or both. In the whole sample, α-SMA score positively correlated with ER-α (p = 0.022) and ER-β expression (p < 0.004). ER-β expression negatively correlated with capsular thickness (p < 0.019). In capsules surrounding expanders α-SMA and ER-α, expressions negatively correlated with time from implantation (p = 0.002 and p = 0.016, respectively). The incidence of grade III-IV contracture was higher in patients who did not have anti-oestrogenic therapy (p < 0.036); retrospective analysis of 233 cases confirmed this finding (p < 0.0001). This study demonstrates the expression of oestrogen receptors in myofibroblasts of capsular tissue. A lower contracture severity was found in patients who underwent anti-oestrogenic therapy.
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico of Rome University, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Persichetti
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico of Rome University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Segreto
authors.affiliation: Center for Integrated Biomedical Research (CIR), Laboratory of Microscopic and Ultrastructural Anatomy, Campus Bio-Medico of Rome University, Rome, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Carotti
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico of Rome University, Rome, Italy. Electronic address: g.marangi@unicampus.it.
authors.forename: Giovanni Francesco
authors.initials: GF
authors.lastname: Marangi
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, Campus Bio-Medico of Rome University, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Tosi
authors.affiliation: Center for Integrated Biomedical Research (CIR), Laboratory of Microscopic and Ultrastructural Anatomy, Campus Bio-Medico of Rome University, Rome, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Morini
mesh_terms: D000199:Actins / Q000032:analysis; D001940:Breast / Q000737:chemistry* / Q000473:pathology*; D018427:Breast Implants / Q000009:adverse effects; D001943:Breast Neoplasms / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000628:therapy; D018275:Carcinoma, Lobular / Q000628:therapy; D003286:Contracture / Q000209:etiology / Q000473:pathology*; D004965:Estrogen Antagonists / Q000627:therapeutic use; D047628:Estrogen Receptor alpha / Q000032:analysis*; D047629:Estrogen Receptor beta / Q000032:analysis*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects*; D008875:Middle Aged; D058628:Myofibroblasts / Q000737:chemistry* / Q000473:pathology; D012189:Retrospective Studies
chemical_list: C541116:ACTA2 protein, human; D000199:Actins; D004965:Estrogen Antagonists; D047628:Estrogen Receptor alpha; D047629:Estrogen Receptor beta
keywords: Anti-oestrogens; Breast implant capsules; Capsular contracture; Oestrogen receptors; Tamoxifen