Published in

Australian Journal of General Practice, 4(50), p. 219-221, 2021

DOI: 10.31128/ajgp-04-20-5360

Elsevier, Advances in Surgery, (55), p. 299-306, 2021

DOI: 10.1016/j.yasu.2021.05.019

Hellenic Journal of Obstetrics and Gynecology, 3(20), p. 117-130, 2021

DOI: 10.33574/hjog.0202

Links

Tools

Export citation

Search in Google Scholar

Breast Implant-Associated Anaplastic Large Cell Lymphoma

Journal article published in 2014 by Lindsay Keith, Wei Yang, Kristin van Busum, Alexandra Travers-Glehen, A. Y.-U. Ustyugov, Sarah E. Tevis, John Matthew Webster, Henry C. Vasconez, John Stewart, Michail Sorotos, Alyson Skelly, Dean Smyth, M. Soto Dopazo, Fabio Santanelli di Pompeo, R. Rao and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

Full text: Download

Question mark in circle
Preprint: policy unknown
Upload
Question mark in circle
Postprint: policy unknown
Upload
Question mark in circle
Published version: policy unknown
Upload

Abstract

BACKGROUND: The authors report four cases of breast implant-associated anaplastic large cell lymphoma (ALCL) from a single institution and propose a multidisciplinary protocol. METHODS: From 2012 to 2014, four breast implant-associated ALCL cases were diagnosed. The authors performed the original operation, and no patients were referred to their practice. Cases 1, 2, and 4 were CD4/CD30/ALK ALCL with previous textured-implant reconstruction, whereas case 3 was CD8/CD30/ALK ALCL with previous polyurethane-implant augmentation. A retrospective study of all patients who underwent breast implant positioning was performed to identify any misdiagnosed cases. RESULTS: Of 483 patients, 226 underwent reconstruction with latissimus dorsi flap and prosthesis, 115 had skin-sparing/nipple-sparing mastectomy and prosthesis, 117 underwent an expander/implant procedure, and 25 underwent breast augmentation. Fifty-eight cases (12 percent) underwent implant replacement for capsular contracture, 15 (3.1 percent) experienced late-onset seroma, and four (0.83 percent) had both capsular contracture and seroma. Seventy-seven symptomatic patients (16 percent) underwent surgical revision (capsulectomy/capsulotomy) and/or seroma evacuation. The second look on histologic specimens did not identify misdiagnosed cases. A multidisciplinary protocol for suspected implant-associated ALCL was established. Ultrasound and cytologic examinations are performed in case of periprosthetic effusion. If implant-associated ALCL is diagnosed, implant removal with capsulectomy is performed. If disseminated disease is detected through positron emission tomography/computed tomography of the total body, the patient is referred to the oncology department. CONCLUSIONS: A multidisciplinary protocol is mandatory for both early diagnosis and patient management. Until definitive data emerge regarding the exact etiopathogenesis of breast implant-associated ALCL, the authors suggest offering only autologous reconstruction if patients desire it.