Anaplastic Large Cell Lymphoma and Breast Implants: A Systematic Review

Abstract

A form of ALCL, which clinically behaves more like the less aggressive primary cutaneous form of ALK-negative ALCL rather than the more aggressive systemic form, may be associated with breast implants. Future research on the epidemiology and biology of this rare disease is clearly needed to better understand its nature.

Medical History, Lifestyle, Family History, and Occupational Risk Factors for Peripheral T-Cell Lymphomas: The InterLymph Non-Hodgkin Lymphoma Subtypes Project

“…The chromosomal translocation t(2;5)(p23;q35), which results in the fusion protein NPM-ALK (2), is found specifically in ALCL. A possible link between breast implants and ALCL has also been reported (13)(14)(15)(16)(17)(18). While these risk factors do not explain the majority of PTCLs that arise, they do suggest that PTCL subtypes may have distinct etiologies.…”

Implant-associated anaplastic large cell lymphoma of the breast: Insight into a poorly understood disease

“…The majority of ALK-1(−) systemic ALCL cases present with painless peripheral lymphadenopathy, B symptoms and stage III or IV disease (23). Implant-associated ALCL overwhelmingly presents as unilateral breast swelling and effusions (9,10).…”

“…In January 2011, the United States Food and Drug Administration (FDA) published an investigation of ALCL and breast implants, which concluded that there is a possible association between breast implants and ALCL; however, the low incidence of ALCL -0.1 to 0.3 per 100,000 -would make proving causality exceedingly difficult (5,6). A multidisciplinary panel of experts reached a similar conclusion (7,8), suggesting an association without a causal relationship between breast implants and ALCL. Other than asserting that an association between implants and ALCL likely exists, no clear consensus regarding ALCL and breast implants has emerged.…”

“…Time to presentation after placement of breast implants has ranged from one to 23 years, and patients' age has ranged from 28 to 87 years (6). The most consistent association is that all cases of breast implantassociated ALCL in which cytology is known, demonstrate strong CD30 positivity and are anaplastic lymphoma kinase-1 (ALK-1) negative (5,7,10). Continued vigilance in reporting cases is needed to further elucidate possible contributing factors.…”

“…Of the known cases of ALCL associated with implants, both saline and silicone implants have been documented (5). It has been reported in patients both receiving implants for cosmetic purposes and for reconstruction secondary to cancer (9). Time to presentation after placement of breast implants has ranged from one to 23 years, and patients' age has ranged from 28 to 87 years (6).…”