Chest wall infiltration is a critical prognostic factor in breast implant-associated anaplastic large-cell lymphoma affected patients

Campanale, Antonella; Napoli, Arianna Di; Ventimiglia, Marco; Pileri, Stefano; Minella, Daniela; Curigliano, Giuseppe; Martelli, Maurizio; Vita, Roy De; Giulio, Paola Di; Montorsi, Marco; Veronesi, Giulia; Giordano, Silvia; Iachino, Achille; Lispi, Lucia

doi:10.1016/j.ejca.2021.01.041

Cited by 9 publications

(14 citation statements)

References 26 publications

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“…The Italian ministerial database records 79 cases of BIA-ALCL (from 2010 to February 2022), including two deaths [ 21 ]. The average time from implantation to the time of diagnosis was 7.77 ± 4.33 years and the most common symptom at presentation was seroma, detected in 90.6% of patients diagnosed with breast-ALCL [ 22 ]. In 40.6% of cases the implants had been placed for aesthetic purposes, while in 59.4% for breast reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Clinical recommendations for diagnosis and treatment according to current updated knowledge on BIA-ALCL

Longo

Napoli²,

Curigliano³

et al. 2022

The Breast

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Section: Discussionmentioning

confidence: 99%

Clinical recommendations for diagnosis and treatment according to current updated knowledge on BIA-ALCL

Longo

Napoli²,

Curigliano³

et al. 2022

The Breast

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“…This data suggests that chest wall invasive disease may warrant a multimodality approach for improved response rate including use of neoadjuvant chemotherapy prior to definitive surgery. In fact, chest wall infiltration is a critical prognostic factor in BIA-ALCL influencing the possibility of performing a surgical radical tumor extirpation [ 16 ]. These uncommon neoplasms also represent a clinical challenge for surgeons as incorrect diagnosis, incomplete resection and unsuccessful reconstruction of thoracic wall defects have resulted in high rates of perioperative morbidity and mortality [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Breast Implant-Associated Anaplastic Large Cell Lymphoma

Premji

Barbieri

Roth

et al. 2022

Case Reports in Hematology

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Introduction. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare disease entity associated with textured breast implants. Though the clinical course is typically indolent, BIA-ALCL can occasionally invade through the capsule into the breast parenchyma with spread to the regional lymph nodes and beyond including chest wall invasive disease. Case. We present the case of a 51-year-old female with a history of bilateral silicone breast implants placed approximately twenty years ago who presented with two months of progressively enlarging right breast mass. Ultrasound-guided biopsy of right breast mass and right axillary lymph node showed CD 30-positive ALK-negative anaplastic large cell lymphoma, and staging work up showed extension of the tumor to chest wall and ribs consistent with advanced disease. She received CHP-BV (cyclophosphamide, doxorubicin, prednisone, and brentuximab vedotin) for six cycles with complete metabolic response. This was followed by extensive surgical extirpation and reconstruction, radiation for residual disease and consolidation with autologous stem cell transplant. She is currently on maintenance brentuximab vedotin with no evidence of active disease post autologous stem cell transplant. Conclusion. Treatment guidelines for advanced chest wall invasive BIA-ALCL are not well defined. Lack of predictive factors warrants mutation analysis and genetic sequencing to identify those at highest risk of progression to chest wall invasive disease. This rare case highlights the need for definitive consensus on the optimal management of chest wall invasive BIA-ALCL.

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“…Several findings, including tumor nodules, bilateral involvement, axillary lymph node dissemination, and histologically infiltrative pattern of the capsule, are known to be associated with aggressive course. 77 In a retrospective review of 44 patients, those in stage I showed a 100% 3-year overall survival and a 63% 3-year eventfree survival. 62 In another cohort study of 87 patients, stage I patients were found to have a 93% overall survival and 63% event-free survival at 3 years.…”

Section: Prognosismentioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

Comprehensive Evaluation of the Current Knowledge on Breast Implant Associated-Anaplastic Large Cell Lymphoma

2022

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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently spotlighted T-cell origin non-Hodgkin's lymphoma with an increasing incidence of over 800 cases and 33 deaths reported worldwide. Development of BIA-ALCL is likely a complex process involving many factors, such as the textured implant surface, bacterial biofilm growth, immune response, and patient genetics. As the incidence of BIA-ALCL is expected to increase, it is important for all surgeons and physicians to be aware of this disease entity and acquire thorough knowledge of current evidence-based guidelines and recommendations. Early detection, accurate diagnosis, and appropriate treatment are the foundations of current care.

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Chest wall infiltration is a critical prognostic factor in breast implant-associated anaplastic large-cell lymphoma affected patients

Cited by 9 publications

References 26 publications

Clinical recommendations for diagnosis and treatment according to current updated knowledge on BIA-ALCL

Clinical recommendations for diagnosis and treatment according to current updated knowledge on BIA-ALCL

An Unusual Case of Breast Implant-Associated Anaplastic Large Cell Lymphoma

Comprehensive Evaluation of the Current Knowledge on Breast Implant Associated-Anaplastic Large Cell Lymphoma

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