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Primary lymphomas of the breast are rare and predominately of B-cell phenotype. Anaplastic large cell lymphoma is a T-cell lymphoma that accounts for only 3% of all non-Hodgkin lymphomas. We present a rare case of primary anaplastic large cell lymphoma of the breast in association with a silicone breast implant capsule in a healthy 40-year-old woman. The patient had bilateral breast implants placed at 21 years of age and presented with painful bilateral breast contractures and associated breast asymmetry. Histology, immunohistochemistry, and T-cell gene rearrangement studies were supportive of a CD 30-positive ALK-1 negative anaplastic large cell lymphoma. This case represents the 14th reported case of primary breast lymphoma in association with breast prosthesis. Of interest is that 11 of these cases were T-cell lymphomas with 8 specifically of the CD30-positive anaplastic large cell lymphoma type. This rare case highlights the importance of histologic examination of breast capsule specimens.

Synopsis Radiation to the chest wall is common before resection of tumors. History of radiation does not necessarily change the surgical approach of soft tissue coverage needed for reconstruction. Osteoradionecrosis can occur after radiation treatment, particularly after high dose radiation treatment. Radical resection and reconstruction is feasible and can be life saving. Soft tissue coverage using myocutaneous flap or omental flap is determined by the quality of soft tissue available and the status of the vascular pedicle supplying available myocutaneous flaps. Radiation induced sarcomas of the chest wall occur most commonly after radiation therapy for breast cancer. While angiosarcomas are the most common histology of radiation induced sarcoma, osteosarcoma, myosarcomas, rhabdomyosarcoma, and undifferentiated sarcomas also occur. The most effective treatment is surgical resection. Tumors not amenable to surgical resection are treated with chemotherapy with low response rates.

For breast cancer patients who have had oncoplastic surgery, the tumor bed is frequently more extensive and possibly relocated compared with original presentation. Placement of surgical clips after tumor resection and before oncoplastic reconstruction may be the most accurate method to localize the RT local boost field.

Lymphomas associated with implants are predominantly of T-cell type-with anaplastic large cell lymphoma (ALCL) being most reported. That said, to date 6 cases of B-cell lymphoma associated with breast implants have been reported. All cases exhibited unilateral breast involvement. Here, the authors report a case of low-grade B-cell lymphoma occurring bilaterally in a 34-year-old woman with a history of Poly Implant Prosthese silicone implants at age 20, T-cell angioimmunoblastic lymphoma, and subsequent myeloablative double cord blood transplantation. Lymphoma cells were positive for CD20, CD5, BCL-2, CD21, CD23, IgD, IgM, with very low Ki-67 of 1%. Nevertheless, cases of ALCL associated with breast implants are rare but much more documented in literature than B-cell lymphomas associated with breast implants, as in this patient. Identification of a relationship between breast cancer and silicone is still ongoing in the literature, with long-term clinical follow-up required. More research will be necessary to fully characterize the occurrence, course, and association of this disease with breast implants in order to properly guide diagnosis and management.

This research aimed to uncover barriers to unemployment faced by young people who are furthest from the labour market. It arises from a research project, ENLIVEN – Encouraging Lifelong Learning for an Inclusive and Vibrant Europe (2016-2019), funded by the European Union’s Horizon 2020 programme, which focuses on interdisciplinary approaches to influencing policy formation. An evaluation of a local employment support service for young people unemployed for 12 months or more was undertaken by computer and social scientists within ENLIVEN. Two data mining approaches were utilised: proximity to the labour market indicator analysis and decision tree analysis of programme participant employment outcomes. An important question considered was whether the decision tree analysis would support anecdotal experience from local practitioners which indicated the relevance of Maslow’s hierarchy of needs to their work within the context of the most vulnerable young people. It was found by decision tree analysis that young people who possess good levels of confidence, mental health and who have worked before are more likely to secure a sustained employment outcome. These findings can be related to Maslow’s hierarchy of needs and support the approach adopted by the Young and Successful programme to aid young people to develop their employability.

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This article is offered as an example of practice-based research, focusing on the concept of praxis : the bringing together of research, theory and action. It does this by exploring the challenges of group work and collaborative thinking, sharing the learning and reflection of a group of civil society practitioners, from a range of different backgrounds and knowledge practices. The group came together under the auspices of the Raymond Williams Foundation, to reflect on 'keywords' that underpin their work in civil society. Using Raymond Williams's approach to hermeneutics, they considered how language is used and embedded within society. The approach allowed for the possibility of critiquing and contesting ideas that have become ideologically or politically dominant. The group considered the keywords 'charity', 'philanthropy' and 'voluntarism', and how their meanings have changed and evolved within society. The debate also brought into focus current concerns about shrinking state provision and consideration of whether the UK is witnessing a renewed focus on charity and corporate philanthropy. Ultimately, the article describes both the tensions and areas of commonality within the group in response to the debate, as well as opening up the group's learning experience to critical examination.