How I treat breast implant–associated anaplastic large cell lymphoma

Author:

Mehta-Shah Neha1ORCID,Clemens Mark W.2,Horwitz Steven M.3

Affiliation:

1. Division of Oncology, Department of Medicine, Washington University in St. Louis, St. Louis, MO;

2. Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX; and

3. Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY

Abstract

Abstract Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) is a recently described form of T-cell non-Hodgkin lymphoma now formally recognized by the World Health Organization classification of lymphoid neoplasms. The disease most often presents with a delayed seroma around the breast implant, almost exclusively with a textured surface, and manifests with breast pain, swelling or asymmetry, capsular contracture, but can also present with a breast mass, and lymph node involvement. The prognosis of BIA-ALCL is favorable compared with many other subtypes of systemic T-cell lymphoma; however, unlike other non-Hodgkin lymphomas, complete surgical excision for localized disease is an important part of the management of these patients. In this paper, we share our recommendations for a multidisciplinary team approach to the diagnosis, workup, and treatment of BIA-ALCL in line with consensus guidelines by the National Comprehensive Cancer Network.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Reference49 articles.

1. The 2016 revision of the World Health Organization classification of lymphoid neoplasms;Swerdlow;Blood,2016

2. NCCN guidelines insights: non-Hodgkin’s lymphomas, version 2.2018;Horwitz;J Natl Compr Canc Netw,2018

3. Anaplastic T-cell lymphoma in proximity to a saline-filled breast implant;Keech;Plast Reconstr Surg,1997

4. US Food and Drug Administration. Anaplastic large cell lymphoma (ALCL) in women with breast implants: preliminary FDA findings and analyses. https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239995.htm. Accessed 1 July 2018.

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