Breast cancer after polyacrylamide hydrogel augmentation: A clinicopathological analysis of 5 cases and literature review

Polyacrylamide hydrogel (PAAG) injection was once widely used for cosmetic breast augmentation in China but was later banned due to severe long-term complications; PAAG deposition can interfere with breast imaging and delay the diagnosis of secondary breast cancer, bringing great clinical challenges. This study retrospectively analyzed 5 female patients diagnosed with breast cancer long after PAAG injection breast augmentation, summarized their clinical data, multimodality imaging manifestations, pathological features and long-term follow-up outcomes, and combined relevant published literature to further characterize this rare patient population. Our results demonstrated that breast cancer arising in PAAG-augmented breasts presents younger onset age, prominent imaging obscuration, high axillary lymph node metastasis rate and poor overall prognosis compared with conventional breast cancer. Routine breast ultrasound is recommended for long-term surveillance of PAAG recipients, and contrast-enhanced magnetic resonance imaging is the preferred examination for evaluating suspicious breast masses; standardized follow-up protocols and active pathological biopsy are essential for early diagnosis and timely intervention.