Breast implant-associated anaplastic large cell lymphoma (ALCL) is a rare type of T-cell non-Hodgkin lymphoma arising around the capsule of breast implants. It has been diagnosed in an extremely small group of women with breast implants for breast reconstruction and augmentation. The pathogenesis of this disease is currently poorly understood, but it appears to be related to textured implants. The aim of this article is to provide patients, radiologists, pathologists, surgical oncologists and plastic surgeons with an evidence-based overview of the incidence, diagnosis, and management of BIA-ALCL according to real-world experience, because although it is very rare, early recognition and surgical resection is usually crucial and curative. NOWOTWORY J Oncol 2018; 68, 1: 15-21
IntroductionAlthough breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is infrequent, with less than 1000 noted cases worldwide, patients consenting for breast implant surgery should be aware of its risk. We describe the first Polish multicenter case-series data on BIA-ALCL patients and present diagnostic and treatment recommendation for breast surgeons.Material and methodsIn cooperation with the Polish Society of Surgical Oncology and Polish Lymphoma Research Group, we collected BIA-ALCL cases in Poland.ResultsWe retrospectively reviewed clinical data of seven BIA-ALCL patients, diagnosed between July 2013 and November 2019. The median time from implant placement to the first BIA-ALCL symptoms was 65 months (range: 33–96 months). All the patients were exposed to textured implants at presentation. Capsulectomy with implant removal was performed in all the patients with immediate reimplantation in 2 cases. In a median follow-up of 19 months (range 5-81 months), there was no recurrence and all the patients stayed alive. Between 2013 and 2019, the incidence of BIA-ALCL in Polish female population age 30 and above ranged from 0 to 0.021/100 000/year.ConclusionsBIA-ALCL is scarce in the Polish population. In a short-term follow-up, patients’ prognosis remains excellent. Due to the withdrawal of roughly textured implants from the market and the exclusion of likely the most potent etiologic factor, it might be expected that the incidence of BIA-ALCL will become even rarer.
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