Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) in Poland: analysis of patient series and practical guidelines for breast surgeons

Author:

Pluta Piotr1,Giza Agnieszka2,Kolenda Małgorzata3,Fendler Wojciech45,Braun Marcin6,Chudobiński Cezary7,Chałubińska-Fendler Justyna6,Araszkiewicz Michał8,Loga Karolina9,Lembas Lubomir10,Witkowska Magdalena11,Pluta Agnieszka12,Kolasiński Jerzy3,Basta Pawel13,Kołacińska-Voytkuv Agnieszka14,Cieśla Sławomir15,Jesionek-Kupnicka Dorota16,Jankau Jerzy17,Kuczyński Maciej18,Kalinka Ewa19,Zadrożny Marek1,Murawa Dawid15

Affiliation:

1. Department of Surgical Oncology and Breast Diseases, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland

2. Department of Hematology, Jagiellonian University Medical College, Krakow, Poland

3. Klinika Kolasinski, Swarzedz, Poland

4. Department of Radiation Oncology, Harvard Medical School, Dana-Farber Cancer Institute, Boston, Massachusetts, USA

5. Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland

6. Department of Radiotherapy, Military Institute of Medicine, Warsaw, Poland

7. Department of Radiology, Regional Oncology Centre, Copernicus Memorial Hospital, Lodz, Poland

8. Legal Advisor’s Office, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland

9. Department of Radiotherapy and General Oncology, Regional Oncology Centre, Copernicus Memorial Hospital in Lodz, Medical University of Lodz, Lodz, Poland

10. Private Practice Lubomir Lembas, Warsaw, Poland

11. Department of Experimental Hematology, Medical University of Lodz, Lodz, Poland

12. Department of Hematology, Medical University of Lodz, Lodz, Poland

13. Departament of Gynecology and Oncology, Jagiellonian University, Medical College Breast Unit of University Hospital, Krakow, Poland

14. Department of Head and Neck Cancer Surgery, Breast Cancer Unit, Medical University of Lodz, Lodz, Poland

15. Clinic of General Surgery and Surgical Oncology, Faculty of Medicine and Health Sciences University, Zielona Gora, Poland

16. Department of Pathology, Chair of Oncology, Medical University of Lodz, Lodz, Poland

17. Department of Plastic Surgery, Gdansk Medical University, Gansk, Poland

18. Dr Maciej Kuczyński Plastic Surgery Center, Lublin, Poland

19. Department of Oncology, Polish Mother’s Memorial Hospital – Research Institute, Lodz, Poland

Abstract

IntroductionAlthough breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is infrequent, with less than 1000 noted cases worldwide, patients consenting for breast implant surgery should be aware of its risk. We describe the first Polish multicenter case-series data on BIA-ALCL patients and present diagnostic and treatment recommendation for breast surgeons.Material and methodsIn cooperation with the Polish Society of Surgical Oncology and Polish Lymphoma Research Group, we collected BIA-ALCL cases in Poland.ResultsWe retrospectively reviewed clinical data of seven BIA-ALCL patients, diagnosed between July 2013 and November 2019. The median time from implant placement to the first BIA-ALCL symptoms was 65 months (range: 33–96 months). All the patients were exposed to textured implants at presentation. Capsulectomy with implant removal was performed in all the patients with immediate reimplantation in 2 cases. In a median follow-up of 19 months (range 5-81 months), there was no recurrence and all the patients stayed alive. Between 2013 and 2019, the incidence of BIA-ALCL in Polish female population age 30 and above ranged from 0 to 0.021/100 000/year.ConclusionsBIA-ALCL is scarce in the Polish population. In a short-term follow-up, patients’ prognosis remains excellent. Due to the withdrawal of roughly textured implants from the market and the exclusion of likely the most potent etiologic factor, it might be expected that the incidence of BIA-ALCL will become even rarer.

Publisher

Termedia Sp. z.o.o.

Subject

General Medicine

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