Download PDF
Handchir Mikrochir Plast Chir 2020; 52(02): 67-74
DOI: 10.1055/a-1111-8841
Übersichtsarbeit

Aktueller Algorithmus zur Diagnostik und Therapie des Brustimplantat-assoziierten anaplastischen großzelligen Lymphoms

An algorithmic approach for diagnosis and treatment of breast implant-associated anaplastic large cell lymphoma
Nicholas Moellhoff
1   Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
,
Konstantin Frank
1   Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
,
Paul S. Wiggenhauser
1   Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
,
Thilo L. Schenck
1   Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
,
Doris Mayr
2   Pathologisches Institut, Ludwig-Maximilians-Universität München, München Deutschland
,
Riccardo E. Giunta
1   Abteilung für Hand-, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Zusammenfassung

Bei elektiven Operationen gilt es ein höchstes Maß an Sicherheit zu gewährleisten und Patienten ausführlich über die mit dem Eingriff verbundenen Risiken zu informieren. Insbesondere bei ästhetischen Eingriffen in der Plastischen Chirurgie ist es die Pflicht des Chirurgen eine ganzheitliche und umfassende Aufklärung auch über mögliche Langzeitfolgen durchzuführen. In den letzten Jahren steht die Verwendung von Brustimplantaten zur ästhetischen Brustaugmentation oder zur Brustrekonstruktion nach Tumorresektion zunehmend im Fokus der Öffentlichkeit, nachdem sich weltweit die Fallzahlen von seltenen Brustimplantat-assoziierten Krankheitsbildern häufen und die Ursachen nicht vollständig geklärt sind. Das breast implant-associated anaplastic large cell lymphoma (engl. BIA-ALCL) wurde 2016 von der Weltgesundheitsorganisation als lymphatische Neoplasie klassifiziert.

Mittlerweile wurden weltweit knapp 800 Fälle, die vor allem texturierte Implantate betreffen, dokumentiert. Die maligne Erkrankung führt zu einer Verunsicherung von Patientinnen mit Implantaten. Daher ist es eine zentrale Aufgabe der Plastischen Chirurgen dieses seltene Krankheitsbild zu verstehen, es frühzeitig zu erkennen und klare Handlungsempfehlungen zu formulieren. Das vorliegende Manuskript soll den aktuellen Stand zum Vorgehen im Hinblick auf Diagnostik und Therapie des BIA-ALCL zusammenfassen.

Abstract

Elective surgeries, especially aesthetic operations in plastic surgery, require surgeons to provide a holistic and comprehensive explanation of possible procedural risks and long-term consequences. Recently, the use of breast implants for aesthetic breast augmentation or breast reconstruction after tumour resection has gained public attention as the numbers of patients with rare breast implant-associated diseases have been rising worldwide, while the aetiopathogenesis remains unclear. BIA-ALCL was classified as a lymphatic neoplasm by the World Health Organization in 2016. Meanwhile, almost 800 cases have been documented, especially in patients that received textured implants. This malignant disease has led to a great level of uncertainty and scepticism in patients and the public. Hence, it is a central task of plastic surgeons to understand this rare disease, to recognise it at an early stage and help those affected by clear recommendations for action. The following manuscript summarises current approaches for diagnosis and treatment.

Schlüsselwörter

Brustaugmentation - Ästhetisch-Plastische Chirurgie - Implantatregister - Brustimplantate - BIA-ALCL

Key words

Breast implant - breast augmentation - central registry - breast implant-associated anaplastic large cell lymphoma


Publication History

Received: 09 December 2019

Accepted: 21 January 2020

Article published online:
07 April 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • Literatur

  • 1 https://www.isaps.org/wp-content/uploads/2018/10/ISAP2016_17_comparison.pdf Zugegriffen: 02.12.2019.
    PubMed
  • 2 The American Society for Aesthetic Plastic Surgery’s Cosmetic Surgery National Data Bank: Statistics 2018. Aesthet Surg J 2019; 39: 1-27
    PubMedGoogle Scholar
  • 3 https://www.dgpraec.de/wp-content/uploads/2019/04/2019–03–28-Statement_ALCL.pdf Zugegriffen: 02.12.2019
    PubMed
  • 4 Coroneos CJ, Selber JC, Offodile 2nd AC. et al. US FDA Breast Implant Postapproval Studies: Long-term Outcomes in 99 993 Patients. Ann Surg 2019; 269: 30-36
    CrossrefPubMedGoogle Scholar
  • 5 Magnusson MR, Cooter RD, Rakhorst H. et al. Breast Implant Illness: A Way Forward. Plast Reconstr Surg 2019; 143: 74S-81S
    CrossrefPubMedGoogle Scholar
  • 6 Rohrich RJ, Kaplan J, Dayan E. Silicone Implant Illness: Science versus Myth?. Plast Reconstr Surg 2019; 144: 98-109
    CrossrefPubMedGoogle Scholar
  • 7 Tang SY, Israel JS, Afifi AM. Breast Implant Illness: Symptoms, Patient Concerns, and the Power of Social Media. Plast Reconstr Surg. 2017 DOI: 10.1097/PRS.0000000000003785
    PubMedGoogle Scholar
  • 8 Loch-Wilkinson A, Beath KJ, Knight RJW. et al. Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand: High-Surface-Area Textured Implants Are Associated with Increased Risk. Plast Reconstr Surg 2017; 140: 645-654
    CrossrefPubMedGoogle Scholar
  • 9 de Boer M, van Leeuwen FE, Hauptmann M. et al. Breast Implants and the Risk of Anaplastic Large-Cell Lymphoma in the Breast. JAMA Oncol 2018; 4: 335-341
    CrossrefPubMedGoogle Scholar
  • 10 Clemens MW, Medeiros LJ, Butler CE. et al. Complete Surgical Excision Is Essential for the Management of Patients With Breast Implant-Associated Anaplastic Large-Cell Lymphoma. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2016; 34: 160-168
    PubMedGoogle Scholar
  • 11 https://www.fda.gov/regulatory-information/search-fda-guidance-documents/breast-implants-certain-labeling-recommendations-improve-patient-communication Zugegriffen 02.12.2019
    PubMed
  • 12 Clemens MW, Miranda RN, Butler CE. Breast Implant Informed Consent Should Include the Risk of Anaplastic Large Cell Lymphoma. Plast Reconstr Surg 2016; 137: 1117-1122
    CrossrefPubMedGoogle Scholar
  • 13 Ebner PJ, Liu A, Gould DJ. et al. Breast implant-associated anaplastic large cell lymphoma, a systematic review and in-depth evaluation of the current understanding. J Surg Oncol 2019; 120: 573-577
    PubMedGoogle Scholar
  • 14 Roden AC, Macon WR, Keeney GL. et al. Seroma-associated primary anaplastic large-cell lymphoma adjacent to breast implants: an indolent T-cell lymphoproliferative disorder. Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc 2008; 21: 455-463
    CrossrefPubMedGoogle Scholar
  • 15 Swerdlow SH, Campo E, Pileri SA. et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016; 127: 2375-2390
    CrossrefPubMedGoogle Scholar
  • 16 Keech Jr. JA, Creech BJ. Anaplastic T-cell lymphoma in proximity to a saline-filled breast implant. Plast Reconstr Surg 1997; 100: 554-555
    CrossrefPubMedGoogle Scholar
  • 17 McCarthy CM, Loyo-Berrios N, Qureshi AA. et al. Patient Registry and Outcomes for Breast Implants and Anaplastic Large Cell Lymphoma Etiology and Epidemiology (PROFILE): Initial Report of Findings, 2012–2018. Plast Reconstr Surg 2019; 143: 65S-73S
    CrossrefPubMedGoogle Scholar
  • 18 https://www.bfarm.de/SharedDocs/Risikoinformationen/Medizinprodukte/DE/Brustimplantate_ALCL_FDA.html Zugegriffen: 24.11.2019
    PubMed
  • 19 Prantl L, von Fritschen U, Liebau J. et al. [Concept for a National Implant Registry to Improve Patient Safety]. Handchir Mikrochir Plast Chir 2016; 48: 320-329
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 de Jong D, Vasmel WL, de Boer JP. et al. Anaplastic large-cell lymphoma in women with breast implants. Jama 2008; 300: 2030-2035
    CrossrefPubMedGoogle Scholar
  • 21 Ghione P, Cordeiro PG, Ni A. et al. Risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) in a cohort of 3546 women prospectively followed after receiving textured breast implants. Journal of Clinical Oncology 2019; 37: 1565-1565
    CrossrefPubMedGoogle Scholar
  • 22 Messingschlager KJ, Mamarvar M. [Breast-implant-associated anaplastic large cell lymphoma (BIA-ALCL) in a lactating breast]. Handchir Mikrochir Plast Chir 2019; 51: 151-152
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 https://www.fda.gov/medical-devices/breast-implants/medical-device-reports-breast-implant-associated-anaplastic-large-cell-lymphoma Zugegriffen: 02.12.2019
    PubMed
  • 24 Swanson E. Plastic Surgeons Defend Textured Breast Implants at 2019 U. S. Food and Drug Administration Hearing: Why It Is Time to Reconsider. Plast Reconstr Surg Glob Open 2019; 7: e2410
    CrossrefPubMedGoogle Scholar
  • 25 https://www.dgpraec.de/wp-content/uploads/2018/12/2018–12–20-Patienteninformation_ALLERGAN.pdf Zugegriffen: 02.12.2019
    PubMed
  • 26 Jones JL, Hanby AM, Wells C. et al. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL): an overview of presentation and pathogenesis and guidelines for pathological diagnosis and management. Histopathology. 2019 DOI: 10.1111/his.13932
    PubMedGoogle Scholar
  • 27 Bizjak M, Selmi C, Praprotnik S. et al. Silicone implants and lymphoma: The role of inflammation. J Autoimmun 2015; 65: 64-73
    CrossrefPubMedGoogle Scholar
  • 28 Hu H, Johani K, Almatroudi A. et al. Bacterial Biofilm Infection Detected in Breast Implant-Associated Anaplastic Large-Cell Lymphoma. Plast Reconstr Surg 2016; 137: 1659-1669
    CrossrefPubMedGoogle Scholar
  • 29 George EV, Pharm J, Houston C. et al. Breast implant-associated ALK-negative anaplastic large cell lymphoma: a case report and discussion of possible pathogenesis. Int J Clin Exp Pathol 2013; 6: 1631-1642
    PubMedGoogle Scholar
  • 30 Mempin M, Hu H, Chowdhury D. et al. The A, B and C’s of Silicone Breast Implants: Anaplastic Large Cell Lymphoma, Biofilm and Capsular Contracture. Materials (Basel) 2018; 11
    PubMedGoogle Scholar
  • 31 Jones P, Mempin M, Hu H. et al. The Functional Influence of Breast Implant Outer Shell Morphology on Bacterial Attachment and Growth. Plast Reconstr Surg 2018; 142: 837-849
    CrossrefPubMedGoogle Scholar
  • 32 Doren EL, Miranda RN, Selber JC. et al. U. S. Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Plast Reconstr Surg 2017; 139: 1042-1050
    CrossrefPubMedGoogle Scholar
  • 33 Brody GS. Anaplastic Large Cell Lymphoma Occurring in Women with Breast Implants: Analysis of 173 Cases. Plast Reconstr Surg 2015; 136: 553e-554e
    CrossrefPubMedGoogle Scholar
  • 34 Clemens MW, Jacobsen ED, Horwitz SM. 2019 NCCN Consensus Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). Aesthet Surg J 2019; 39: S3-S13
    CrossrefPubMedGoogle Scholar
  • 35 James GA, Boegli L, Hancock J. et al. Bacterial Adhesion and Biofilm Formation on Textured Breast Implant Shell Materials. Aesthetic Plast Surg 2019; 43: 490-497
    CrossrefPubMedGoogle Scholar
  • 36 Shauly O, Gould DJ, Siddiqi I. et al. The First Reported Case of Gluteal Implant-Associated Anaplastic Large Cell Lymphoma (ALCL). Aesthet Surg J 2019; 39: NP253-NP258
    CrossrefPubMedGoogle Scholar
  • 37 Mendes J, Mendes Maykeh VA, Frascino LF. et al. Gluteal Implant Associated Anaplastic Large Cells Lymphoma. Plast Reconstr Surg. 2019 DOI: 10.1097/PRS.0000000000005910
    PubMedGoogle Scholar
  • 38 Brody GS, Deapen D, Taylor CR. et al. Anaplastic large cell lymphoma occurring in women with breast implants: analysis of 173 cases. Plast Reconstr Surg 2015; 135: 695-705
    CrossrefPubMedGoogle Scholar
  • 39 Laurent C, Delas A, Gaulard P. et al. Breast implant-associated anaplastic large cell lymphoma: two distinct clinicopathological variants with different outcomes. Annals of oncology : official journal of the European Society for Medical Oncology/ESMO 2016; 27: 306-314
    CrossrefPubMedGoogle Scholar
  • 40 Di Napoli A, Pepe G, Giarnieri E. et al. Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma. PloS one 2017; 12: e0181097
    CrossrefPubMedGoogle Scholar
  • 41 Berlin E, Singh K, Mills C. et al. Breast Implant-Associated Anaplastic Large Cell Lymphoma: Case Report and Review of the Literature. Case Rep Hematol 2018; 2018: 2414278
    PubMedGoogle Scholar
  • 42 Clemens MW, Brody GS, Mahabir RC. et al. How to Diagnose and Treat Breast Implant-Associated Anaplastic Large Cell Lymphoma. Plast Reconstr Surg 2018; 141: 586e-599e
    CrossrefPubMedGoogle Scholar
  • 43 Kricheldorff J, Fallenberg EM, Solbach C. et al. Breast Implant-Associated Lymphoma. Dtsch Arztebl Int 2018; 115: 628-635
    PubMedGoogle Scholar
  • 44 Miranda RN, Aladily TN, Prince HM. et al. Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2014; 32: 114-120
    PubMedGoogle Scholar
  • 45 Zimmerman A, Locke FL, Emole J. et al. Recurrent Systemic Anaplastic Lymphoma Kinase-Negative Anaplastic Large Cell Lymphoma Presenting as a Breast Implant-Associated Lesion. Cancer Control 2015; 22: 369-373
    CrossrefPubMedGoogle Scholar
  • 46 Vose J, Armitage J, Weisenburger D. et al. International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2008; 26: 4124-4130
    CrossrefPubMedGoogle Scholar
  • 47 Kao EY, Lynch DT. Cancer, Lymphoma, ALK Negative Anaplastic Large Cell. In StatPearls. Treasure Island (FL). 2019
    PubMedGoogle Scholar
  • 48 https://dejure.org/gesetze/SGB_V/52.html Zugegriffen: 21.12.2019
    PubMed