Late Seromas after Breast Implants

Spear, Scott L.; Rottman, Steven J.; Glicksman, Caroline; Brown, Mitchell H.; Al-Attar, Ali

doi:10.1097/prs.0b013e3182589ea9

Cited by 105 publications

(60 citation statements)

References 19 publications

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“…All cases of implant-associated ALCL in which surface type is known have reported textured implants as the type of implant (28,32). It is well known that textured implants have been associated with late-onset seromas but their association with ALCL is less clear (12,33). Because ALCL is a result of T cell activation and expansion, some have argued that ALCL may be a result of an immunogenic response (27).…”

Section: Discussionmentioning

confidence: 99%

“…This has made it difficult to analyze the cases in the literature. Initial management of a late-onset seroma or peri-implant mass associated with a breast implant has evolved into a more standardized approach (11)(12)(13). In an attempt to gather consistent data from case to case for analysis, the FDA and the American Society of Plastic Surgeons recommend collecting and reporting specific data to their registry (Table 2) (5).…”

Section: Discussionmentioning

confidence: 99%

“…These findings also suggested extracapsular implant rupture. Ultrasound-guided aspiration yielded 1200 mL of light-yellow fluid, which was sent for cytology and culture as recommended in the literature (11)(12)(13). Cytology revealed features consistent with ALCL and CD30 positivity, and was negative for ALK-1.…”

Section: Abstract: Anaplastic Large Cell Lymphoma; Breast Implant; Lmentioning

confidence: 99%

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Implant-associated anaplastic large cell lymphoma of the breast: Insight into a poorly understood disease

Weathers¹,

Wolfswinkel²,

Hatef³

et al. 2013

CAN J PLAST SURG

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A naplastic large cell lymphoma (ALCL) is the subject of increasing scrutiny among plastic surgeons and the public. Accounting for only 3% of all non-Hodgkin's lymphoma and 0.5% of all breast cancers, ALCL is rare (1-4). Multiple reports have highlighted a possible relationship between ALCL in the breast and breast implants. In January 2011, the United States Food and Drug Administration (FDA) published an investigation of ALCL and breast implants, which concluded that there is a possible association between breast implants and ALCL; however, the low incidence of ALCL -0.1 to 0.3 per 100,000 -would make proving causality exceedingly difficult (5,6). A multidisciplinary panel of experts reached a similar conclusion (7,8), suggesting an association without a causal relationship between breast implants and ALCL. Other than asserting that an association between implants and ALCL likely exists, no clear consensus regarding ALCL and breast implants has emerged.In the literature, contributing factors for implant-associated ALCL have not been established. Of the known cases of ALCL associated with implants, both saline and silicone implants have been documented (5). It has been reported in patients both receiving implants for cosmetic purposes and for reconstruction secondary to cancer (9). Time to presentation after placement of breast implants has ranged from one to 23 years, and patients' age has ranged from 28 to 87 years (6). The most consistent association is that all cases of breast implantassociated ALCL in which cytology is known, demonstrate strong CD30 positivity and are anaplastic lymphoma kinase-1 (ALK-1) negative (5,7,10). Continued vigilance in reporting cases is needed to further elucidate possible contributing factors.The majority of what is known about ALCL is derived from case reports. The data from these reports are somewhat limited in that not all contain complete details. A standard work-up for suspected new cases has been recommended by the FDA to ensure that all pertinent information is obtained from each case in the future (5). This will ensure accurate and complete information, and further the study of ALCL and its relationship with breast implants. Using these new recommendations, we present one case of implant-associated ALCL that presented to our facility. Case presentationA 44-year-old female underwent bilateral subglandular breast augmentation in 2005 in Mexico with 410 mL CUI round-textured silicone implants (Allergan, USA) through an inframammary approach. The patient experienced no immediate postoperative complications and had an uneventful course until her presentation to the Ben Taub General Hospital (Texas, USA) seven years after surgery.In 2012, the patient presented to the Ben Taub General Hospital emergency department complaining of progressive left breast swelling and erythema for three months. The patient denied fever, chills or symptoms of systemic toxicity. The patient had no recent history of trauma or breastfeeding. On presentation, the patient was afebrile and hemodynamical...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Abstract: Anaplastic Large Cell Lymphoma; Breast Implant; Lmentioning

confidence: 99%

See 1 more Smart Citation

Implant-associated anaplastic large cell lymphoma of the breast: Insight into a poorly understood disease

Weathers¹,

Wolfswinkel²,

Hatef³

et al. 2013

CAN J PLAST SURG

View full text Add to dashboard Cite

show abstract

“…Benign late seromas most commonly follow blunt external trauma (i.e., Motor vehicle accident, closed capsulectomy) or low grade infection, however they can also occur in the absence of any discernible precipitating event (68-70) (Figure 8). Spear and colleagues reported a 5-year experience of 28 late seromas encountered in 25 patients (71). The authors found that 96 percent had a Biocell (Allergan) textured device in place at the time of seroma development.…”

Section: Benign Delayed Seromasmentioning

confidence: 99%

Understanding rare adverse sequelae of breast implants: anaplastic large-cell lymphoma, late seromas, and double capsules

et al. 2017

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“…In the FDA study, 10 of the 34 patients presented with a seroma that was positive for ALCL cells. Seromas have been shown to be associated with Biocell (Allergan, USA) textured implants (9,10). In the five cases reported from Australia, all implants were textured (6).…”

Section: Keymentioning

confidence: 99%