The management of breast implant-associated anaplastic large cell lymphoma in the setting of pregnancy: seeking for clinical practice guidelines

Abstract

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently described form of T-cell non-Hodgkin lymphoma now formally recognized by the World Health Organization classification of lymphoid neoplasms. The aim of this paper is to report the first case of BIA-ALCL diagnosed in a pregnant patient. It is well known that BIA-ALCL appears as an indolent lymphoma with a good prognosis when diag-nosed at early stages and clinical guidelines for its management have been clearly published. Nevertheless, they lack a standardized approach for BIA-ALCL during pregnancy. With limited experience in our case, treatment has been safely postponed after term without affecting patient’s overall prognosis and without fetal complication. The fact that the disease was diagnosed at an early stage (stage I) undoubtedly influenced the course of treatment. A multidisciplinary approach weighing the risks and benefits of treatment is of paramount importance in order to ensure the best possible outcome for both the mother and her child and clinical update guidelines should be issued.

Breast Implant-Associated Anaplastic Large Cell Lymphoma Presenting in a Postpartum Patient: A Case Report

“…However, based on the literature and our patient’s case, diagnosis and management appears to follow traditional guidelines. In the first case report published on BIA-ALCL discovered during pregnancy, the patient underwent a similar workup to the patient presented in our report, aside from not undergoing mammography imaging, likely to avoid radiation exposure during pregnancy [ 12 ]. The patient was able to carry the pregnancy to term with no fetal complications [ 12 ].…”

“…In the first case report published on BIA-ALCL discovered during pregnancy, the patient underwent a similar workup to the patient presented in our report, aside from not undergoing mammography imaging, likely to avoid radiation exposure during pregnancy [ 12 ]. The patient was able to carry the pregnancy to term with no fetal complications [ 12 ]. Bilateral mastectomy, which was curative for the patient’s disease, was deferred until delivery, which did not affect the patient’s prognosis [ 12 ].…”

“…The patient was able to carry the pregnancy to term with no fetal complications [ 12 ]. Bilateral mastectomy, which was curative for the patient’s disease, was deferred until delivery, which did not affect the patient’s prognosis [ 12 ]. While these isolated cases provide preliminary insights, it is essential to acknowledge the unique nature of each situation.…”