Our Experience in Diagnosing and Treating Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Author:

Shoham Gon1ORCID,Haran Oriana1ORCID,Singolda Roei1,Madah Ehab1,Magen Ada2,Golan Orit3,Menes Tehillah4,Arad Ehud1,Barnea Yoav1ORCID

Affiliation:

1. Department of Plastic and Reconstructive Surgery, Tel Aviv Sourasky Medical Center, Affiliated with the Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel

2. Breast Health Center, Tel Aviv Sourasky Medical Center, Affiliated with the Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel

3. Breast Imaging Center, Tel Aviv Sourasky Medical Center, Affiliated with the Faculty of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel

4. Meirav Breast Center, Sheba Medical Center, Affiliated with the Faculty of Medicine, Tel Aviv University, Tel Hashomer 5262000, Israel

Abstract

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T-cell lymphoma detected in association with textured implants. It presents as a fluid accumulation around the implant, usually years after the implantation. We present our experience in diagnosing and treating four patients with BIA-ALCL, each widely differing from the other. Data on patients’ surgical history, relevant medical information, and findings on pathological slides were retrieved from their medical charts and retrospectively reviewed. Each of the four patients was diagnosed with BIA-ALCL, one after breast augmentation, one after breast reconstruction with an implant, one after breast reconstruction with a latissimus dorsi flap and implant, and the fourth after the removal of breast implants. The cases were presented to a multidisciplinary team and subsequently underwent surgery. All four are currently free of tumors, as established by a negative follow-up via positron emission tomography-computed tomography. Although the incidence of BIA-ALCL is rare, these cases emphasize the need to rule out the diagnosis of BIA-ALCL in patients with textured implants or a history of implanted textured devices who present with symptoms such as late seroma or peri-implant mass. This pathology is typically indolent and slow-growing and heightened awareness for an early diagnosis could lead to quicker intervention and enhanced patient management.

Publisher

MDPI AG

Subject

General Medicine

Reference24 articles.

1. Anaplastic T-Cell Lymphoma in Proximity to a Saline-Filled Breast Implant;Keech;Plast. Reconstr. Surg.,1997

2. Food and Drug Administration (2022). Medical Device Reports of Breast Implant-Associated Anaplastic Large Cell Lymphoma, FDA.

3. Risk of Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) in a Cohort of 3546 Women Prospectively Followed Long Term after Reconstruction with Textured Breast Implants;Cordeiro;J. Plast. Reconstr. Aesthetic Surg.,2020

4. BIA-ALCL Epidemiology in an Aesthetic Breast Surgery Cohort of 1501 Patients;Sorotos;Aesthet. Surg. J.,2023

5. Food and Drug Administration (2022, August 06). Allergan Voluntarily Recalls BIOCELL® Textured Breast Implants and Tissue Expanders, Available online: https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/allergan-voluntarily-recalls-biocellr-textured-breast-implants-and-tissue-expanders.

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