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Breast implant-associated anaplastic large-cell lymphoma: a European case report and literature review

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Summary

Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCLC) is an infrequent T‑cell neoplasm that accounts for approximately 3% of non-Hodgkin lymphomas. After the first case of BIA-ALCL, an increasing number of scientific works concerning BIA-ALCL have been published. We report and discuss the case of BIA-ALCL in a 66-year-old Caucasian woman presented with swelling, pain, redness and a seroma that had developed around the breast implant. After establishing the diagnosis of BIA-ALCL (stage IC, T3N0M0 according to the BIA-ALCL staging system), she underwent several breast implant procedures and capsulectomies. We also provide the results of a literature review on the incidence, clinical management, diagnosis and therapy of this disease.

“Level of evidence: level IV case report with literature review”

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References

  1. Rocco N, Rispoli C, Moja L, et al. Different types of implants for reconstructive breast surgery. Cochrane Database Syst Rev. 2016; https://doi.org/10.1002/14651858.CD010895.pub2.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Berry MG, Davies DM. Breast augmentation: part i—a review of the silicone prosthesis. J Plast Reconstr Aesthet Surg. 2010;63:1761–8.

    CAS  PubMed  Google Scholar 

  3. Spear SL, Parikh PM, Goldstein JA. History of breast implants and the food and drug administration. Clin Plast Surg. 2009;36:15–21.

    PubMed  Google Scholar 

  4. Berry MG, Cucchiara V, Davies DM. Breast augmentation: part III-preoperative considerations and planning. J Plast Reconstr Aesthet Surg. 2011;64:1401–9.

    CAS  PubMed  Google Scholar 

  5. Xu J, Wei S. Breast implant-associated anaplastic large cell lymphoma: review of a distinct clinicopathologic entity. Arch Pathol Lab Med. 2014;138:842–6.

    PubMed  Google Scholar 

  6. Bizjak M, Selmi C, Praprotnik S, et al. Silicone implants and lymphoma: the role of inflammation. J Autoimmun. 2015;65:64–73.

    CAS  PubMed  Google Scholar 

  7. Thompson PA, Lade S, Webster H, Ryan G, Prince HM. Effusion-associated anaplastic large cell lymphoma of the breast: time for it to be defined as a distinct clinico-pathological entity. Haematologica. 2010;95:1977–9.

    PubMed  PubMed Central  Google Scholar 

  8. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127:2375–90.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. McCarthy CM, Loyo-Berríos N, Qureshi AA, et al. Patient registry and outcomes for breast implants and anaplastic large cell Lymphoma etiology and epidemiology (PROFILE): initial report of findings, 2012–2018. Plast Reconstr Surg. 2019;143:65S–73S.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Groth K, Graf R. Breast implant-associated anaplastic large cell Lymphoma (BIA-ALCL) and the textured breast implant crisis. Aesthetic Plast Surg. 2020;44:1–12.

    Google Scholar 

  11. di Pompeo FS, Sorotos M, Clemens MW, Firmani G, European Association of Plastic Surgeons (EURAPS) Committee on device safety and development. Breast Implant–Associated Anaplastic Large Cell Lymphoma (BIA-ALCL): Review of epidemiology and prevalence assessment in Europe. Aesthet Surg J. 2020. https://doi.org/10.1093/asj/sjaa285.

    Article  Google Scholar 

  12. Quesada AE, Medeiros LJ, Clemens MW, Ferru MC, Miranda RN, Miranda RN. Breast implant-associated anaplastic large cell lymphoma: a review disorder. Modern Pathol. 2019;32:166–188.

    Google Scholar 

  13. Case Report guidelines C. CARE Checklist of information to include when writing a case report. 2016; : 13.

  14. Grant Stevens W, Bradley Calobrace M, Alizadeh K, Zeidler KR, Harrington JL, d’Incelli RC. Ten-year core study data for sientra’s food and drug administration—approved round and shaped breast implants with cohesive silicone gel. Plast Reconstr Surg. 2018;141:7S–19S.

    PubMed  Google Scholar 

  15. Kendall B, Sawyer RJ, Chang H, et al. No 主観的健康感を中心とした在宅高齢者における 健康関連指標に関する共分散構造分析 Title. Foresight. 2019;23:1–9.

    Google Scholar 

  16. Gunawardana RT, Dessauvagie BF, Taylor DB. Breast implant-associated anaplastic large cell lymphoma, an under-recognised entity. J Med Imaging Radiat Oncol. 2019;63:630–8.

    PubMed  Google Scholar 

  17. Gidengil CA, Predmore Z, Mattke S, Van Busum K, Kim B. Breast implant-associated anaplastic large cell lymphoma: a systematic review. Plast Reconstr Surg. 2015;135:713–20.

    CAS  PubMed  Google Scholar 

  18. Yoshida SH, Swan S, Teuber SS, Gershwin ME. Silicone breast implants: immunotoxic and epidemiologic issues. Life Sci. 1995;56:1299–310.

    CAS  PubMed  Google Scholar 

  19. Kricheldorff J, Fallenberg EM, Solbach C, Gerber-Schäfer C, Rancsó C, Von Fritschen U. Brustimplantat-assoziiertes Lymphom. Dtsch Arztebl Int. 2018;115:625–35. übersichtsarbeit.

    Google Scholar 

  20. Lazzeri D, Agostini T, Bocci G, et al. ALK-1-negative anaplastic large cell lymphoma associated with breast implants: a new clinical entity. Clin Breast Cancer. 2011;11:283–96.

    PubMed  Google Scholar 

  21. Zucca E, Bertoni F, Vannata B, Cavalli F. Emerging role of infectious etiologies in the pathogenesis of marginal zone B‑cell lymphomas. Clin Cancer Res. 2014;20:5207–16.

    CAS  PubMed  Google Scholar 

  22. Hu H, Jacombs A, Vickery K, Merten SL, Pennington DG, Deva AK. Chronic biofilm infection in breast implants is associated with an increased t‑cell lymphocytic infiltrate: Implications for breast implant-associated lymphoma. Plast Reconstr Surg. 2015;135:319–29.

    CAS  PubMed  Google Scholar 

  23. Hu H, Johani K, Almatroudi A, et al. Bacterial biofilm infection detected in breast implant-associated anaplastic large-cell lymphoma. Plast Reconstr Surg. 2016;137:1659–69.

    CAS  PubMed  Google Scholar 

  24. Laurent C, Nicolae A, Laurent C, et al. Gene alterations in epigenetic modifiers and JAK-STAT signaling are frequent in breast implant–associated ALCL. Blood. 2020;135:360–70.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Technologies A, Diego S. Targeted next generation sequencing of breast implant—associated anaplastic large cell lymphoma reveals mutations in JAK/STAT signalling pathway genes, TP53 and DNMT3A. Br J Haematol. 2018;180:735–760.

    Google Scholar 

  26. Blombery P, Thompson E, Ryland GL, et al. Oncotarget. 2018;9:36126–36.

    PubMed  PubMed Central  Google Scholar 

  27. Tabanelli V, Corsini C, Fiori S, et al. Recurrent PDL1 expression and PDL1 (CD274) copy number alterations in breast implant–associated anaplastic large cell lymphomas. Hum Pathol. 2019;90:60–9.

    CAS  PubMed  Google Scholar 

  28. Berlin E, Singh K, Mills C, Shapira I, Bakst RL, Chadha M. Breast implant-associated anaplastic large cell lymphoma: case report and review of the literature. Case Rep Hematol. 2018. https://doi.org/10.1155/2018/2414278.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Chacko A, Lloyd T. Breast implant-associated anaplastic large cell lymphoma: a pictorial review. Insights Imaging. 2018;9:683–6.

    PubMed  PubMed Central  Google Scholar 

  30. Marra A, Viale G, Pileri SA, et al. Breast implant-associated anaplastic large cell lymphoma: A comprehensive review. Cancer Treat Rev. 2020;84:101963.

    CAS  PubMed  Google Scholar 

  31. Freeman. 乳鼠心肌提取 HHS public access. Physiol Behav. 2018;176:139–48.

    Google Scholar 

  32. Leberfinger AN, Behar BJ, Williams NC, et al. Breast implant-associated anaplastic large cell lymphoma: a systematic review. JAMA Surg. 2017;152:1161–8.

    PubMed  Google Scholar 

  33. Brody GS, Deapen D, Taylor CR, et al. Anaplastic large cell lymphoma occurring in women with breast implants: analysis of 173 casesa. Plast Reconstr Surg. 2015;135:695–705.

    CAS  PubMed  Google Scholar 

  34. Doren EL, Miranda RN, Selber JC, et al. U.S. epidemiology of breast implant-associated anaplastic large cell lymphoma. Plast Reconstr Surg. 2017;139:1042–50.

    CAS  PubMed  Google Scholar 

  35. Clemens MW, Jacobsen ED, Horwitz SM. 2019 NCCN consensus guidelines on the diagnosis and treatment of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Aesthet Surg J . 2019;39:S3–S13.

    PubMed  Google Scholar 

  36. Mehta-Shah N, Clemens MW, Horwitz SM. How I treat breast implant–associated anaplastic large cell lymphoma. Blood. 2018;132:1889–98.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Chott A, Vonderheid EC, Olbricht S, Miao NN, Balk SP, Kadin ME. The same dominant T cell clone is present in multiple regressing skin lesions and associated T cell lymphomas of patients with lymphomatoid papulosis. J Invest Dermatol. 1996;106:696–700.

    CAS  PubMed  Google Scholar 

  38. Laurent C, Delas A, Gaulard P, et al. Breast implant-associated anaplastic large cell lymphoma: two distinct clinicopathological variants with different outcomes. Ann Oncol. 2016;27:306–14.

    CAS  PubMed  Google Scholar 

  39. Ten Berge RL, Oudejans JJ, Ossenkoppele GJ, et al. ALK expression in extranodal anaplastic large cell lymphoma layouts systemic disease with (primary) nodal involvement and a good prognosis and occurs before dissemination. J Clin Pathol. 2000;53:445–50.

    CAS  PubMed  Google Scholar 

  40. Gascoyne RD, Aoun P, Wu D, et al. Prognostic significance of anaplastic lymphoma kinase (ALK) protein expression in adults with anaplastic large cell lymphoma. Blood. 1999;93:3913–21.

    CAS  PubMed  Google Scholar 

  41. Munakata W, Terauchi T, Maruyama D, Nagai H. Revised staging system for malignant lymphoma based on the Lugano classification. Jpn J Clin Oncol. 2019;49:895–900.

    PubMed  Google Scholar 

  42. Clemens MW, Medeiros LJ, Butler CE, et al. Complete surgical excision is essential for the management of patients with breast implant-associated anaplastic large-cell lymphoma. J Clin Oncol. 2016;34:160–8.

    CAS  PubMed  Google Scholar 

  43. Younes A, Bartlett NL, Leonard JP, et al. Brentuximab vedotin (SGN-35) for relapsed CD30-positive lymphomas. N Engl J Med. 2010;363:1812–21.

    CAS  PubMed  Google Scholar 

  44. Prince HM, Kim YH, Horwitz S, et al. Brentuximab vedotin or physician’s choice in CD30-positive cutaneous T‑cell lymphoma (ALCANZA): an international, open-label, randomised, phase 3, multicentre trial. Lancet. 2017;390:555–66.

    CAS  PubMed  Google Scholar 

  45. Johnson L, O’Donoghue JM, McLean N, et al. Breast implant associated anaplastic large cell lymphoma: The UK experience. Recommendations on its management and implications for informed consent. Eur J Surg Oncol. 2017;43:1393–401.

    CAS  PubMed  Google Scholar 

  46. Zimmerman A, Locke FL, Emole J, et al. Recurrent systemic anaplastic lymphoma kinase–negative anaplastic large cell lymphoma presenting as a breast implant–associated lesion. Cancer Control. 2015;22:369–72.

    PubMed  Google Scholar 

  47. Hwang MJ, Brown H, Murrin R, Momtahan N, Sterne GD. Breast implant-associated anaplastic large cell Lymphoma: a case report and literature review. Aesthetic Plast Surg. 2015;39:391–5.

    PubMed  Google Scholar 

  48. Tardío JC, Granados R. Axillary lymphadenopathy: an outstanding presentation for breast implant-associated ALK-negative anaplastic large cell lymphoma. Int J Surg Pathol. 2015;23:424–8.

    PubMed  Google Scholar 

  49. Ezekwudo DE, Ifabiyi T, Gbadamosi B, et al. Breast implant–associated anaplastic large cell lymphoma: a case report and review of the literature. Case Rep Oncol Med. 2017. https://doi.org/10.1155/2017/6478467.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Clemens MW, Miranda RN, Butler CE. Breast implant informed consent should include the risk of anaplastic large cell lymphoma. Plast Reconstr Surg. 2016;137:1117–22.

    CAS  PubMed  Google Scholar 

  51. Platt J, Baxter N, Zhong T. Breast reconstruction after mastectomy for breast cancer. CMAJ. 2011;183:2109–16.

    PubMed  PubMed Central  Google Scholar 

  52. Somogyi RB, Ziolkowski N, Osman F, Ginty A, Brown M. Breast reconstruction: updated overview for primary care physicians. Can Fam Physician. 2018;64:424–32.

    PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Spedali Civili di Brescia, Piazzale Spedali Civili, 1, 25123, Brescia, BS, Italy

    Federico Ghidinelli M.D.

  2. Department of surgery, Spedali Civili di Brescia, Brescia, Italy

    Luigi Filippini M.D., Paola Porsio M.D., Federico Canzi M.D., Rino Balzano M.D., Elisa Flocchini M.D. & Anna Bianchi M.D.

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  1. Federico Ghidinelli M.D.
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  2. Luigi Filippini M.D.
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Correspondence to Federico Ghidinelli M.D..

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F. Ghidinelli, L. Filippini, P. Porsio, F. Canzi, R. Balzano, E. Flocchini and A. Bianchi declare that they have no competing interests.

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For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case. For images or other information within the manuscript which identify patients, consent was obtained from them and/or their legal guardians.

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Ghidinelli, F., Filippini, L., Porsio, P. et al. Breast implant-associated anaplastic large-cell lymphoma: a European case report and literature review. memo 15, 229–235 (2022). https://doi.org/10.1007/s12254-021-00714-4

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  • DOI: https://doi.org/10.1007/s12254-021-00714-4

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