Skip to main content

Advertisement

SpringerLink
Log in

Breast implant-associated anaplastic large cell lymphoma: sensitivity, specificity, and findings of imaging studies in 44 patients

  • Review
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Breast implant-associated anaplastic large cell lymphoma (BIA ALCL) is a newly described clinicopathologic entity. The purpose of this study is to describe the imaging findings of patients with BIA ALCL and determine their sensitivity and specificity in the detection of the presence of an effusion or a mass related to BIA ALCL. A retrospective search was performed of our files as well as of the world literature for patients with pathologically proven BIA ALCL who had been assessed by any imaging study including ultrasound (US), computerized tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET)–CT, as well as mammography. The sensitivity and specificity of each imaging modality in the detection of an effusion or a mass around breast implants was determined. We identified 44 patients who had BIA ALCL and imaging studies performed between 1997 and 2013. The sensitivity for detecting an effusion was 84, 55, 82, and 38 %, and for detecting a mass was 46, 50, 50, and 64 %, by US, CT, MRI, and PET, respectively. The sensitivity of mammography in the detection of an abnormality without distinction of effusion or mass was 73 %, and specificity 50 %. Progression-free survival was worse in patients with an implant-associated mass (p = 0.001). Conclusions: Current imaging with US, CT, MR, and PET appears suboptimal in the detection of an imaging abnormality associated with BIA ALCL. This under diagnosis may reflect a lack of awareness of this rare entity suggesting the need for better understanding of the spectrum of imaging findings associated with BIA ALCL by breast imagers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Talwalkar SS, Miranda RN, Valbuena JR, Routbort MJ, Martin AW, Medeiros LJ (2008) Lymphomas involving the breast: a study of 106 cases comparing localized and disseminated neoplasms. Am J Surg Pathol 32(9):1299–1309. doi:10.1097/PAS.0b013e318165eb50

    Article  PubMed  Google Scholar 

  2. Keech JA Jr, Creech BJ (1997) Anaplastic T-cell lymphoma in proximity to a saline-filled breast implant. Plast Reconstr Surg 100(2):554–555

    Article  PubMed  Google Scholar 

  3. Miranda RN, Lin L, Talwalkar SS, Manning JT, Medeiros LJ (2009) Anaplastic large cell lymphoma involving the breast: a clinicopathologic study of 6 cases and review of the literature. Arch Pathol Lab Med 133(9):1383–1390. doi:10.1043/1543-2165-133.9.1383

    PubMed  Google Scholar 

  4. Thompson PA, Prince HM (2013) Breast implant-associated anaplastic large cell lymphoma: a systematic review of the literature and mini-meta analysis. Curr Hematol Malig Rep 8(3):196–210. doi:10.1007/s11899-013-0164-3

    Article  PubMed  Google Scholar 

  5. Miranda RN, Aladily TN, Prince HM, Kanagal-Shamanna R, de Jong D, Fayad LE, Amin MB, Haideri N, Bhagat G, Brooks GS, Shifrin DA, O’Malley DP, Cheah CY, Bacchi CE, Gualco G, Li S, Keech JA Jr, Hochberg EP, Carty MJ, Hanson SE, Mustafa E, Sanchez S, Manning JT Jr, Xu-Monette ZY, Miranda AR, Fox P, Bassett RL, Castillo JJ, Beltran BE, de Boer JP, Chakhachiro Z, Ye D, Clark D, Young KH, Medeiros LJ (2014) Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients. J Clin Oncol 32(2):114–120. doi:10.1200/JCO.2013.52.7911JCO.2013.52.7911

    Article  PubMed Central  PubMed  Google Scholar 

  6. Aladily TN, Medeiros LJ, Amin MB, Haideri N, Ye D, Azevedo SJ, Jorgensen JL, de Peralta-Venturina M, Mustafa EB, Young KH, You MJ, Fayad LE, Blenc AM, Miranda RN (2012) Anaplastic large cell lymphoma associated with breast implants: a report of 13 cases. Am J Surg Pathol 36:1000–1008. doi:10.1097/PAS.0b013e31825749b1

    Article  PubMed  Google Scholar 

  7. Mendelson EB, Baum JK, Berg WA et al (2003) Ultrasound. In: D’Orsi CJ, Mendelson EB, Ikeda DM et al (eds) Breast imaging reporting and data system: ACR BI-RADS—breast imaging atlas, 1st edn. American College of Radiology, Reston

    Google Scholar 

  8. Ikeda DM, Hylton NM, Kuhl CK et al (2003) Magnetic resonance imaging. In: D’Orsi CJ, Mendelson EB, Ikeda DM et al (eds) Breast imaging reporting and data system: ACR BI-RADS—breast imaging atlas, 1st edn. American College of Radiology, Reston

    Google Scholar 

  9. Edwards SD, Lipson JA, Ikeda DM, Lee JM (2013) Updates and revisions to the BI-RADS magnetic resonance imaging lexicon. Magn Reson Imaging Clin N Am 21(3):483–493. doi:10.1016/j.mric.2013.02.005

    Article  PubMed  Google Scholar 

  10. Lazarus E, Mainiero MB, Schepps B, Koelliker SL, Livingston LS (2006) BI-RADS lexicon for US and mammography: interobserver variability and positive predictive value. Radiology 239(2):385–391. doi:10.1148/radiol.2392042127

    Article  PubMed  Google Scholar 

  11. D’Orsi CJ, Bassett LW, Berg WA et al (2003) Mammography. In: D’Orsi CJ, Mendelson EB, Ikeda DM et al (eds) Breast imaging reporting and data system: ACR BI-RADS—breast imaging atlas, 4th edn. American College of Radiology, Reston

    Google Scholar 

  12. Alobeid B, Sevilla DW, El-Tamer MB, Murty VV, Savage DG, Bhagat G (2009) Aggressive presentation of breast implant-associated ALK-1 negative anaplastic large cell lymphoma with bilateral axillary lymph node involvement. Leuk Lymphoma 50(5):831–833. doi:10.1080/10428190902795527

    Article  CAS  PubMed  Google Scholar 

  13. Bishara MR, Ross C, Sur M (2009) Primary anaplastic large cell lymphoma of the breast arising in reconstruction mammoplasty capsule of saline filled breast implant after radical mastectomy for breast cancer: an unusual case presentation. Diagn Pathol 4:11. doi:10.1186/1746-1596-4-11

    Article  PubMed Central  PubMed  Google Scholar 

  14. Carty MJ, Pribaz JJ, Antin JH, Volpicelli ER, Toomey CE, Farkash EA, Hochberg EP (2011) A patient death attributable to implant-related primary anaplastic large cell lymphoma of the breast. Plast Reconstr Surg 128(3):112e–118e. doi:10.1097/PRS.0b013e318221db96

    Article  CAS  PubMed  Google Scholar 

  15. Farace F, Bulla A, Marongiu F, Campus GV, Tanda F, Lissia A, Cossu A, Fozza C, Rubino C (2013) Anaplastic large cell lymphoma of the breast arising around mammary implant capsule: an Italian report. Aesthetic Plast Surg 37(3):567–571. doi:10.1007/s00266-013-0120-6

    Article  PubMed  Google Scholar 

  16. Farkash EA, Ferry JA, Harris NL, Hochberg EP, Takvorian RW, Zuckerman DS, Sohani AR (2009) Rare lymphoid malignancies of the breast: a report of two cases illustrating potential diagnostic pitfalls. J Hematopathol 2(4):237–244. doi:10.1007/s12308-009-0043-y

    Article  Google Scholar 

  17. Gaudet G, Friedberg JW, Weng A, Pinkus GS, Freedman AS (2002) Breast lymphoma associated with breast implants: two case-reports and a review of the literature. Leuk Lymphoma 43(1):115–119

    Article  PubMed  Google Scholar 

  18. George EV, Pharm J, Houston C, Al-Quran S, Brian G, Dong H, Hai W, Reeves W, Yang LJ (2013) Breast implant-associated ALK-negative anaplastic large cell lymphoma: a case report and discussion of possible pathogenesis. Int J Clin Exp Pathol 6(8):1631–1642

    PubMed Central  PubMed  Google Scholar 

  19. Lazzeri D, Agostini T, Giannotti G, Fanelli G, Colizzi L, Pantaloni M, Sordi E (2011) Null-type anaplastic lymphoma kinase-negative anaplastic large cell lymphoma arising in a silicone breast implant capsule. Plast Reconstr Surg 127(6):159e–162e. doi:10.1097/PRS.0b013e318213a1bd

    Article  CAS  PubMed  Google Scholar 

  20. Lechner MG, Lade S, Liebertz DJ, Prince HM, Brody GS, Webster HR, Epstein AL (2011) Breast implant-associated, ALK-negative, T-cell, anaplastic, large-cell lymphoma: establishment and characterization of a model cell line (TLBR-1) for this newly emerging clinical entity. Cancer 117(7):1478–1489. doi:10.1002/cncr.25654

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Li S, Lee AK (2009) Silicone implant and primary breast ALK1-negative anaplastic large cell lymphoma, fact or fiction? Int J Clin Exp Pathol 3(1):117–127

    PubMed  Google Scholar 

  22. Newman MK, Zemmel NJ, Bandak AZ, Kaplan BJ (2008) Primary breast lymphoma in a patient with silicone breast implants: a case report and review of the literature. J Plast Reconstr Aesthet Surg 61(7):822–825

    Article  PubMed  Google Scholar 

  23. 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):56–57

    Article  CAS  PubMed  Google Scholar 

  24. Smith TJ, Ramsaroop R (2012) Breast implant related anaplastic large cell lymphoma presenting as late onset peri-implant effusion. Breast 21(1):102–104. doi:10.1016/j.breast.2011.07.007

    Article  PubMed  Google Scholar 

  25. Sorensen K, Murphy J, Lennard A, Wadehra V, Menon GK, Collis N (2013) Anaplastic large cell lymphoma in a reconstructed breast using a silicone implant: a UK case report. J Plast Reconstr Aesthet Surg. doi:10.1016/j.bjps.2013.09.015

    Google Scholar 

  26. Taylor KO, Webster HR, Prince HM (2012) Anaplastic large cell lymphoma and breast implants: five Australian cases. Plast Reconstr Surg 129(4):610e–617e. doi:10.1097/PRS.0b013e3182450aae

    Article  CAS  PubMed  Google Scholar 

  27. Wong AK, Lopategui J, Clancy S, Kulber D, Bose S (2008) Anaplastic large cell lymphoma associated with a breast implant capsule: a case report and review of the literature. Am J Surg Pathol 32(8):1265–1268. doi:10.1097/PAS.0b013e318162bcc1

    Article  PubMed  Google Scholar 

  28. Zakhary JM, Hamidian Jahromi A, Chaudhery S, Kim M (2013) Anaplastic large cell lymphoma in the setting of textured breast implant: a call for patients and physicians education. J La State Med Soc 165(1):26–29

    PubMed  Google Scholar 

  29. Parthasarathy M, Orrell J, Mortimer C, Ball L (2013) Chemotherapy-resistant breast implant-associated anaplastic large cell lymphoma. BMJ Case Rep 2013. doi:10.1136/bcr-2013-201950bcr2013201950

  30. Ivaldi C, Perchenet AS, Jallut Y, Casanova D (2013) About two cases of lymphoma in implant capsule: a difficult diagnosis, an unknown pathology. Ann Chir Plast Esthet 58(6):688–693. doi:10.1016/j.anplas.2013.04.003

    Article  CAS  PubMed  Google Scholar 

  31. Bautista-Quach MA, Nademanee A, Weisenburger DD, Chen W, Kim YS (2013) Implant-associated primary anaplastic large-cell lymphoma with simultaneous involvement of bilateral breast capsules. Clin Breast Cancer 13(6):492–495. doi:10.1016/j.clbc.2013.08.009

    Article  PubMed  Google Scholar 

  32. Lee M, Cooper B, Becker D (2012) Keeping abreast of axillary masses. Lancet 380(9852):1530. doi:10.1016/S0140-6736(12)61334-8

    Article  PubMed  Google Scholar 

  33. Weathers WM, Wolfswinkel EM, Hatef DA, Lee EI, Hollier LH, Brown RH (2013) Implant-associated anaplastic large cell lymphoma of the breast: insight into a poorly understood disease. Can J Plast Surg 21(2):95–98

    PubMed Central  PubMed  Google Scholar 

  34. Yang WT, Lane DL, Le-Petross HT, Abruzzo LV, Macapinlac HA (2007) Breast lymphoma: imaging findings of 32 tumors in 27 patients. Radiology 245(3):692–702. doi:10.1148/radiol.2452061726

    Article  PubMed  Google Scholar 

  35. Ilica AT, Kocacelebi K, Savas R, Ayan A (2011) Imaging of extranodal lymphoma with PET/CT. Clin Nucl Med 36(10):e127–e138. doi:10.1097/RLU.0b013e31821c99cd

    Article  PubMed  Google Scholar 

  36. Bengtson B, Brody GS, Brown MH, Glicksman C, Hammond D, Kaplan H, Maxwell GP, Oefelein MG, Reisman NR, Spear SL, Jewell ML (2011) Managing late periprosthetic fluid collections (seroma) in patients with breast implants: a consensus panel recommendation and review of the literature. Plast Reconstr Surg 128(1):1–7. doi:10.1097/PRS.0b013e318217fdb0

    Article  CAS  PubMed  Google Scholar 

  37. Park BY, Lee DH, Lim SY, Pyon JK, Mun GH, Oh KS, Bang SI (2014) Is late seroma a phenomenon related to textured implants? A report of rare complications and a literature review. Aesthetic Plast Surg 38(1):139–145. doi:10.1007/s00266-013-0232-z

    Article  PubMed  Google Scholar 

Download references

Ethical Standards

This is a retrospective study and no experimental work was performed. Patient protection of confidentiality was carried throughout the study. This retrospective study was approved by the University of Texas M.D. Anderson Cancer Center Institutional Review Board (IRB).

Conflict of interest

Author Mark W. Clemens, M.D declares Consultantship and advisory role with Allergan Corp. The rest of the authors declare that they have no conflicts of interest, no financial disclosures and/or acknowledgements; and no funding sources for the work described in the manuscript.

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology Unit 1350, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA

    Beatriz E. Adrada, Gaiane Margishvili Rauch, Elsa Arribas & Wei Yang

  2. Department of Hematopathology Unit 72, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Roberto N. Miranda, Rashmi Kanagal-Shamanna, Jesse Jaso, M. James You, Ken H. Young & L. Jeffrey Medeiros

  3. Department of Plastic Surgery, Unit 1488, MD Anderson Cancer Center, 1400 Pressler St., Houston, TX, 77030, USA

    Mark W. Clemens

  4. Department of Lymphoma and Myeloma, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Michelle Fanale

  5. Saint Lukes Cancer Institute, 4321 Washington St, Medical Plaza Bldg 3, Suite 4000, Kansas City, MO, 64111, USA

    Nisreen Haideri

  6. Plastic and Reconstructive Surgery, Wichita Falls, TX, USA

    Eid Mustafa

  7. Trinity Mother Frances Hospitals and Clinics, 520 E. Douglas, Tyler, TX, 75702, USA

    John Larrinaga

  8. Department of Plastic Surgery, Baylor College of Medicine, Houston, TX, 77030, USA

    Neal R. Reisman

Authors
  1. Beatriz E. Adrada
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roberto N. Miranda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gaiane Margishvili Rauch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elsa Arribas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rashmi Kanagal-Shamanna
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mark W. Clemens
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michelle Fanale
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Nisreen Haideri
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Eid Mustafa
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. John Larrinaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Neal R. Reisman
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jesse Jaso
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. M. James You
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Ken H. Young
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. L. Jeffrey Medeiros
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Wei Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wei Yang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Adrada, B.E., Miranda, R.N., Rauch, G.M. et al. Breast implant-associated anaplastic large cell lymphoma: sensitivity, specificity, and findings of imaging studies in 44 patients. Breast Cancer Res Treat 147, 1–14 (2014). https://doi.org/10.1007/s10549-014-3034-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-014-3034-3

Keywords

Search

Navigation