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Tamoxifen Reduces The Foreign Body Response To Silicone Implants In A Mouse Model
Jenny C. Barker, M.D., Ph.D.1, Kevin Blum, Ph.D.1, Gabriel Mirhaidari, Ph.D.2, Jacob Zbinden, Ph.D.2, Christopher Breuer, M.D.2.
1Ohio State University, Columbus, OH, USA, 2Nationwide Children's Hospital, Columbus, OH, USA.

Purpose: Capsular contracture (CC) is a common issue after implant-based breast reconstruction, affecting up to 20% of patients. CC is a multifactorial phenomenon occurring, in part, as a result of the foreign body response (FBR). New evidence in other surgical models suggests that tamoxifen may mitigate the FBR. We sought to determine if tamoxifen could similarly reduce the FBR in a model of silicone breast implantation.Methods: C57BL/6 female mice were treated with daily tamoxifen or control injections and implanted with bilateral silicone implants in the sub-mammary glandular plane. Implants were removed en bloc after 2 weeks and the FBR was evaluated histologically.Results: Tamoxifen treatment decreased capsule thickness, decreased the number of αSMA+ cells (477156 cells/mm control vs 295121 cells/mm tamoxifen, p=0.005 unpaired t-test) and decreased CD31+ neovessels (173.996.1 vessels/mm2 control vs 106.351.8 vessels/mm2 tamoxifen, p=0.043 unpaired t-test). There were similar amounts of pro- and anti-inflammatory macrophages (iNOS 336.1226.3 cells/mm control vs 290.6104.2 cells/mm tamoxifen, p>0.999 Mann-Whitney test and CD163 136.676.4 cells/mm control vs 94.145.9 cells/mm tamoxifen, p=0.108 unpaired t-test).Conclusions: Tamoxifen treatment in the mouse silicone breast implant model decreased the FBR through modulation of myofibroblasts, neovascularization, and collagen deposition. Tamoxifen may be useful for reducing or preventing capsule formation in clinical breast implantations.


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