Advertisement

Aesthetic Plastic Surgery

, Volume 42, Issue 6, pp 1492–1498 | Cite as

Breast Implant-Associated Anaplastic Large Cell Lymphoma: Immediate or Delayed Implant Replacement?

  • Julien J. Shine
  • Elie Boghossian
  • Gabriel Beauchemin
  • Vasilios W. Papanastasiou
  • Daniel E. BorsukEmail author
Original Article Breast Surgery

Abstract

Introduction

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare and recently described type of peripheral T-cell lymphoma. Fewer than 550 cases have been reported worldwide. Although BIA-ALCL is usually indolent, early diagnosis and treatment have been shown to improve outcome.

Case Description

This case report describes the management of a 50-year-old healthy Caucasian woman presenting with rapid painful enlargement of the left breast. Imaging revealed findings consistent with BIA-ALCL. This diagnosis was confirmed by fine needle aspiration cytology and subsequent pathological analysis. Bilateral removal of implants, complete left capsulectomy and immediate bilateral implant exchange were performed.

Conclusion

No consensus currently exists regarding optimal time of implant exchange and management of the contralateral capsule. The immediate replacement with smooth implants was thoroughly discussed with the patient and endorsed by expert opinion, given complete removal of the disease. There was no sign of recurrence at 6 months. Close clinical and radiological visits are planned for the next years.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords

BIA-ALCL Anaplastic large cell lymphoma Breast implant lymphoma Case report Total capsulectomy Immediate implant replacement 

Notes

Acknowledgements

The authors would like to thank Dr. Mark W. Clemens of the MD Anderson Cancer Center for his valued advice regarding BIA-ALCL and contribution to this report. The authors would also like to acknowledge Dr. Tony Petrella for his generous contribution in the histopathological analysis of this case.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Swerdlow SH, Campo E, Pileri SA et al (2016) The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 127(20):2375–2390CrossRefGoogle Scholar
  2. 2.
    Jacobsen E (2006) Anaplastic large-cell lymphoma, T-/null-cell type. Oncologist 11(7):831–840CrossRefGoogle Scholar
  3. 3.
    Clemens MW, Jacobsen E. Breast implant-associated anaplastic large cell lymphoma [Document on the internet]. UpToDate; 19 April 2017 [Cited 2017 October 13]. https://www.uptodate.com/contents/breast-implant-associated-anaplastic-large-cell-lymphoma?search=bia%20alcl&source=search_result&selectedTitle=1~7&usage_type=default&display_rank=1
  4. 4.
    Keech JA Jr, Creech BJ (1997) Anaplastic T-cell lymphoma in proximity to a saline-filled breast implant. Plast Reconstr Surg 100(2):554–555CrossRefGoogle Scholar
  5. 5.
    United States. U.S. Food and Drug Administration (2017) Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). [Document on the internet]. U.S. FDA: BIA-ALCL; 2017 [cited 2017 October 13]. https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239995.htm. Accessed 15 Oct 2017
  6. 6.
    Olack B, Gupta R, Brooks GS (2007) Anaplastic large cell lymphoma arising in a saline breast implant capsule after tissue expander breast reconstruction. Ann Plast Surg 59(1):56–57CrossRefGoogle Scholar
  7. 7.
    Lazzeri D, Agostini T, Bocci G et al (2011) ALK-1-negative anaplastic large cell lymphoma associated with breast implants: a new clinical entity. Clin Breast Cancer 11(5):283–296CrossRefGoogle Scholar
  8. 8.
    Leberfinger AN, Behar BJ, Williams NC, Rakszawski KL, Potochny JD, Mackay DR et al (2017) Breast implant-associated anaplastic large cell lymphoma: a systematic review. JAMA Surg 152(12):1161–1168CrossRefGoogle Scholar
  9. 9.
    Loch-Wilkinson A, Beath KJ, Knight RJW, Wessels WLF, Magnusson M, Papadopoulos T et al (2017) Breast implant-associated anaplastic large cell lymphoma in Australia and New Zealand: high-surface-area textured implants are associated with increased risk. Plast Reconstr Surg 140(4):645–654CrossRefGoogle Scholar
  10. 10.
    Clemens MW, Medeiros LJ, Butler CE, Hunt KK, Fanale MA, Horwitz S et al (2016) Complete surgical excision is essential for the management of patients with breast implant-associated anaplastic large-cell lymphoma. J Clin Oncol 34(2):160–168CrossRefGoogle Scholar
  11. 11.
    Clemens MW, Brody GS, Mahabir RC, Miranda RN (2018) How to diagnose and treat breast implant-associated anaplastic large cell lymphoma. Plast Reconstr Surg 141(4):586e–599eCrossRefGoogle Scholar
  12. 12.
    National Comprehensive Cancer Network. About NCCN. www.nccn.org/about. Accessed 10 Nov 2017
  13. 13.
    Clemens MW, Horwitz SM (2017) NCCN consensus guidelines for the diagnosis and management of breast implant-associated anaplastic large cell lymphoma. Aesthet Surg J 37(3):285–289CrossRefGoogle Scholar
  14. 14.
    Miranda RN, Aladily TN, Prince HM, Kanagal-Shamanna R, de Jong D, Fayad LE et al (2014) Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients. J Clin Oncol 32(2):114–120CrossRefGoogle Scholar
  15. 15.
    Alhamad S, Guerid S, El Fakir EH, Biron P, Tourasse C, Delay E (2016) Breast implant-associated anaplastic large cell lymphoma. Case report of an undiagnosed form, management and reconstruction (ALCL). Ann Chir Plast Esthet 61(3):223–230CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  • Julien J. Shine
    • 1
  • Elie Boghossian
    • 1
  • Gabriel Beauchemin
    • 1
  • Vasilios W. Papanastasiou
    • 2
  • Daniel E. Borsuk
    • 1
    • 3
    Email author
  1. 1.Department of Plastic and Reconstructive Surgery, Hôpital Maisonneuve-RosemontUniversité de MontréalMontrealCanada
  2. 2.Department of Plastic and Reconstructive SurgeryMcGill University Health CenterMontrealCanada
  3. 3.Hôpital Sainte-JustineMontrealCanada

Personalised recommendations