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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
1   Department of Plastic Surgery, MD Anderson Cancer Center, Houston, Texas
,
Ryan C. DeCoster
2   Lucille P. Markey Cancer Center, University of Kentucky, Lexington, Kentucky
3   Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Kentucky, Lexington, Kentucky
,
Berry Fairchild
4   Department of Surgery, University of Texas Health Science Center, Houston, Texas
,
Alexander A. Bessonov
5   City Cancer Center, St. Petersburg, Russia
,
Fabio Santanelli di Pompeo
6   Department of Plastic Surgery, Sant'Andrea Hospital, “Sapienza” University of Rome, Italy
› Author Affiliations Funding Sources Dr. DeCoster is supported by a National Cancer Institute Surgeon-Scientist training grant (T32CA160003).
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Publication History

Publication Date:
17 October 2019 (online)

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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
 

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