The Spectrum of Non-neoplastic Changes Associated With Breast Implants

Author:

Marques-Piubelli Mario L.12,Lyapichev Kirill A.3,FNU Aakash1,Adrada Beatriz4,Stewart John5,Hunt Kelly K.6,Clemens Mark W.7,Iyer Swaminathan8,Wu Yun5,El Hussein Siba9,Xu Jie1,Ok Chi Young1,Li Shaoying1,Pierson Diane M.10,Ferrufino-Schmidt Maria C.11,Nahmod Karen A.1,Yoga Arthy12,Hunsicker Lisa13,Evans Mark G.14,Resetkova Erika5,Qiu Lianqun15,Khanlari Mahsa16,Garces Sofia A.1,Bueso-Ramos Carlos E.1,Medeiros L. Jeffrey1,Miranda Roberto N.1

Affiliation:

1. Department of Hematopathology

2. Department of Translational Molecular Pathology

3. Department of Pathology, University of Texas Medical Branch, Galveston, TX

4. Department of Breast Imaging

5. Department of Pathology

6. Department of Breast Surgical Oncology

7. Department of Plastic Surgery

8. Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, Houston

9. Department of Pathology, The University of Vermont Larner College of Medicine, Burlington, VT

10. Department of Pathology, Kings Daughters Medical Center, Ashland, KY

11. Universidad Peruana Cayetano Heredia, Lima, Peru and Roche Diagnostics, Lima, Peru

12. Houston Methodist, Breast Surgical Oncology, Houston, TX

13. Revalla Plastic Surgery and Medical Esthetics, Denver, CO

14. Caris Life Sciences, Phoenix, AZ

15. Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA

16. Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN

Abstract

Breast implant-associated anaplastic large cell lymphoma has been recognized as a distinct entity in the World Health Organization classification of hematolymphoid neoplasms. These neoplasms are causally related to textured implants that were used worldwide until recently. Consequently, there is an increased demand for processing periprosthetic capsules, adding new challenges for surgeons, clinicians, and pathologists. In the literature, the focus has been on breast implant-associated anaplastic large cell lymphoma; however, benign complications related to the placement of breast implants occur in up to 20% to 30% of patients. Imaging studies are helpful in assessing patients with breast implants for evidence of implant rupture, changes in tissues surrounding the implants, or regional lymphadenopathy related to breast implants, but pathologic examination is often required. In this review, we couple our experience with a review of the literature to describe a range of benign lesions associated with breast implants that can be associated with different clinical presentations or pathogenesis and that may require different diagnostic approaches. We illustrate the spectrum of the most common of these benign disorders, highlighting their clinical, imaging, gross, and microscopic features. Finally, we propose a systematic approach for the diagnosis and handling of breast implant specimens in general.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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