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

Shine, Julien J.; Boghossian, Elie; Beauchemin, Gabriel; Papanastasiou, Vasilios W.; Borsuk, Daniel E.

doi:10.1007/s00266-018-1204-0

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…For the contralateral side, given the lack of clinical concern for ALCL, we replaced the textured breast implant with a smooth, round silicone breast implant according to standard of care. 22 , 26 …”

Section: Discussionmentioning

confidence: 99%

Breast Implanted-Associated Anaplastic Large Cell Lymphoma: A Case of Advanced Disease with Flow Cytometric Findings

et al. 2022

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Breast implant-associated anaplastic large cell lymphoma (breast implant-associated ALCL) is a recently described, distinct clinicopathological entity associated with macrotextured breast implants. The diagnostic workup of a patient suspected to have breast implant-associated ALCL includes cytological assessment of effusions and tissue biopsies of any masses or enlarged lymph nodes, with morphologic and immunophenotypic evaluation and possible flow cytometric and molecular testing. We report the case of a woman found to have breast implant-associated ALCL on fine needle aspirate and core biopsy, who on surgical resection, had extensive local disease with involvement of the resection margins and lymph nodes, requiring systemic treatment. We focus on the flow cytometric findings that identified a population of large cells on the CD30/side scatter dot plot and whose immunophenotype was consistent with breast implant-associated ALCL, highlighting the value of flow cytometry as an adjunct to morphological and immunophenotypic evaluation.

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Section: Discussionmentioning

confidence: 99%

Breast Implanted-Associated Anaplastic Large Cell Lymphoma: A Case of Advanced Disease with Flow Cytometric Findings

et al. 2022

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“…After surgical treatment, patients may undergo reconstruction, which can entail immediate reconstruction with autograft deep inferior epigastric perforators (DIEPs), DIEP flap or fat transplantation, or a delayed procedure. Owing to the change in anatomic architecture and diagnostic difficulties in evaluating lymphoma response, particularly for the mass-forming subtype, it is suggested that patients with more advanced stages of disease (TNM stages II-IV) should undergo delayed reconstruction (7,65,66).…”

Section: Breast Reconstructionmentioning

confidence: 99%

Breast Implant–associated Anaplastic Large Cell Lymphoma: Review and Multiparametric Imaging Paradigms

et al. 2020

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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a new provisional category in the 2016 World Health Organization (WHO) classification of lymphoid neoplasms, and its incidence is rising owing to increasing recognition of this complication of breast implant insertion. At a median of 10 years after implant insertion, the typical presenting features are sudden-onset breast swelling secondary to peri-implant effusion and less frequently mass-forming disease. Histologic features comprise pleomorphic cells expressing CD30 and negative anaplastic lymphoma kinase (ALK) receptor, similar to systemic and cutaneous ALKnegative anaplastic large cell lymphoma (ALCL). The effusion-only subtype is generally indolent and curable with surgery, unlike the more aggressive mass-forming disease, for which systemic therapy is advocated. High clinical suspicion and pertinent use of radiologic and pathology modalities are essential for timely and accurate diagnosis of BIA-ALCL. Contemporary imaging techniques including US, mammography, breast MRI, CT, and PET/CT are routinely used in breast disease and lymphomas; however, the unique behavior of BIA-ALCL pre sents significant diagnostic and radiologic interpretative challenges, with numerous nuanced imaging features being pertinent, and current lymphoma staging and response guidelines are not easily applicable to BIA-ALCL. The authors evaluate available evidence in this evolving field; detail key indications, strengths, and limitations of the panoply of radiologic techniques for BIA-ALCL; and propose multiparametric imaging paradigms for management of the peri-implant effusion and massforming or advanced disease subtypes, with the goal of accurate optimal patient care. The authors also predict a future model of multimodal assessment using novel imaging and molecular techniques and define key research directions. © RSNA, 2020 • radiographics.rsna.org

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“…1,26,27,30 Removal of the contralateral breast implant at the time of surgery is not mandated by guidelines, but reports of occult contralateral BIA-ALCL in patients undergoing implant removal with preoperatively diagnosed lymphoma should be discussed with patients. 33 There are sparse studies evaluating the optimal timing of implant replacement following removal for BIA-ALCL. Early data suggest immediate replacement is safe and has some advantages over delayed replacement, but surgeons should choose smooth implants and treat every patient on a case-by-case basis.…”

Section: Evaluation and Management Of Bia-alclmentioning

confidence: 99%

“…Early data suggest immediate replacement is safe and has some advantages over delayed replacement, but surgeons should choose smooth implants and treat every patient on a case-by-case basis. 33…”

Section: Evaluation and Management Of Bia-alclmentioning

confidence: 99%

“…For patients with evidence of lymphoma extending beyond the implant capsule or residual disease in the breast due to inability to completely resect the tumor, adjuvant therapy is indicated. 1,29,33 Adjuvant therapy decisions should be made in a multidisciplinary setting on a case-by-case basis, but in general radiation therapy (24–36 Gy) is advocated for residual local disease in patients without a history of prior chest wall radiation, and chemotherapy is advocated for patients with positive lymph nodes or evidence of spread to distant sites. The most common chemotherapeutic agents or regimens include brentuximab vedotin, a monoclonal antibody targeting CD30 with individual case reports demonstrating efficacy in BIA-ALCL, or chemotherapy combinations recommended for peripheral T-cell lymphomas such as cyclophosphamide, doxorubicin, vincristine, and prednisone or variations thereof.…”

Section: Evaluation and Management Of Bia-alclmentioning

confidence: 99%

See 1 more Smart Citation

Synchronous Breast Implant–associated Anaplastic Large Cell Lymphoma and Invasive Carcinoma: Genomic Profiling and Management Implications

Mukhtar

Holland

Sieber³

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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

Abstract: 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 .

Cited by 7 publications

References 12 publications

Breast Implanted-Associated Anaplastic Large Cell Lymphoma: A Case of Advanced Disease with Flow Cytometric Findings

Breast Implanted-Associated Anaplastic Large Cell Lymphoma: A Case of Advanced Disease with Flow Cytometric Findings

Breast Implant–associated Anaplastic Large Cell Lymphoma: Review and Multiparametric Imaging Paradigms

Synchronous Breast Implant–associated Anaplastic Large Cell Lymphoma and Invasive Carcinoma: Genomic Profiling and Management Implications

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