Erschienen in:
15.07.2023 | Breast Oncology
Oncological Outcomes After Multidisciplinary Management of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)
verfasst von:
Rachel L. O’Connell, MBBS, BSc, MD(res), FRCS, Bhupinder Sharma, BSc, BM, FRCR, PhD, Dima El-Sharkawi, MBBS, PhD, Andrew Wotherspoon, MBBCh, FRCPath, Ayoma D. Attygalle, MBBS, FRCPath, PhD, Fiona MacNeill, MBBS, MD, FRCS, Aadil A. Khan, MPH, PhD, FRCS(Plast), Marios-Konstantinos Tasoulis, MD, PhD, FEBS, FRCS
Erschienen in:
Annals of Surgical Oncology
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Ausgabe 10/2023
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Abstract
Introduction
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon type of non-Hodgkin lymphoma, associated with breast implant capsules. Despite improvements in our understanding of BIA-ALCL, communicating the prognosis to patients remains challenging due to limited long-term follow-up data. This has important implications for decision-making, including recommendations for subsequent reconstructive procedures. The aim of this study was to assess the longer-term oncological outcomes of patients receiving multidisciplinary treatment for BIA-ALCL.
Methods
This was a retrospective cohort study of BIA-ALCL patients treated at a tertiary referral unit. The data are presented using simple descriptive statistics.
Results
Between 2015 and 2022, 18 BIA-ALCL patients were treated at our institution. The median age at diagnosis was 48.5 (IQR 41–55) years. Ten patients developed BIA-ALCL after cosmetic breast augmentation, and 8 after breast reconstruction following mastectomy for cancer. All patients had a history of textured implant insertion. The median time from first implant surgery to diagnosis was 8.5 (IQR 7–12) years. All patients underwent en-bloc total capsulectomy with implant removal, and 2 received systemic therapy. Fifteen patients had Stage I (IA–IC) disease, 2 had Stage IIA and 1 Stage III BIA-ALCL, based on the TNM classification system. At a median follow-up of 45 (IQR 15–71) months, there were no episodes of local or systemic relapse or death.
Conclusions
Surgical management for BIA-ALCL is sufficient in early-stage disease, and associated with excellent oncological outcomes. This information is reassuring for patients when discussing recurrence risk.