Finding Consensus After Two Decades of Breast Implant-Associated Anaplastic Large Cell Lymphoma

Mark W. Clemens; Ryan C. DeCoster; Berry Fairchild; Alexander A. Bessonov; Fabio Santanelli di Pompeo

doi:10.1055/s-0039-1696998

Seminars in Plastic Surgery, Table of Contents

Semin Plast Surg 2019; 33(04): 270-278
DOI: 10.1055/s-0039-1696998

Review Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Finding Consensus After Two Decades of Breast Implant-Associated Anaplastic Large Cell Lymphoma

Mark W. Clemens

¹Department of Plastic Surgery, MD Anderson Cancer Center, Houston, Texas

,

Ryan C. DeCoster

²Lucille P. Markey Cancer Center, University of Kentucky, Lexington, Kentucky

³Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Kentucky, Lexington, Kentucky

,

Berry Fairchild

⁴Department of Surgery, University of Texas Health Science Center, Houston, Texas

,

Alexander A. Bessonov

⁵City Cancer Center, St. Petersburg, Russia

,

Fabio Santanelli di Pompeo

⁶Department of Plastic Surgery, Sant'Andrea Hospital, “Sapienza” University of Rome, Italy

› Author Affiliations

Abstract

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an emerging and indolent, but potentially fatal cancer of the immune system that can develop around textured-surface breast implants. The World Health Organization first recognized BIA-ALCL as a unique clinical entity in 2016. To date, over 600 confirmed cases have been reported worldwide. BIA-ALCL most commonly presents with disease confined to the capsule, as a seroma or a mass adjacent to the implant. While BIA-ALCL has a fairly indolent clinical course, with an excellent prognosis in early stage disease, disseminated cancer and death have also been reported. In this review, the authors focus on the early diagnosis and treatment, including reconstructing the breast following BIA-ALCL, and also discuss recently updated National Comprehensive Cancer Network guidelines. They also review the current epidemiology and risk factors associated with BIA-ALCL. Finally, they discuss important medicolegal considerations and the bioethics surrounding the continued use of textured-surface breast implants.

Keywords

breast implant-associated ALCL - anaplastic large cell lymphoma - non-Hodgkin lymphoma - CD30 - double capsule - and Late Seroma

Full Text

References

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