Breast implant-associated anaplastic large cell lymphoma

P. Rastogi, A. K. Deva, H. Miles Prince*

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    33 Citations (Scopus)

    Abstract

    Purpose of Review: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently recognised malignancy of T lymphocytes exclusively associated with textured breast implants. This review aims to evaluate existing theories regarding the epidemiology, pathogenesis, clinical evaluation and management of the disease. Recent Findings: The true incidence of BIA-ALCL is difficult to define. Prevailing pathogenic theories recognise the interplay between textured implants, Gram-negative bacteria, host genetics (e.g. JAK/STAT, p53) and time. Patients typically present with a delayed seroma and less commonly with a capsular mass or systemic disease at an average of 8–10 years after implantation. BIA-ALCL staging has evolved from a “liquid tumour” model to a “solid tumour” classification. For localised disease, surgery involving complete capsulectomy and implant removal is the cornerstone of treatment. For more advanced disease, treatment includes surgery followed by chemotherapy (combination anthracycline-based), radiotherapy and the antibody drug conjugate (brentuximab vedotin). Summary: The interplay between the Gram-negative biofilm, implant texturing, genetic mutations and time has been implicated in pathogenesis of BIA-ALCL. The identification of a putative infectious cause is not unique to lymphomagenesis. Future research, investigating BIA-ALCL genetic mutations and immunological modulation with Gram-negative biofilm in BIA-ALCL models is warranted.

    Original languageEnglish
    Pages (from-to)516-524
    Number of pages9
    JournalCurrent Hematologic Malignancy Reports
    Volume13
    Issue number6
    DOIs
    Publication statusPublished - 1 Dec 2018

    Keywords

    • Anaplastic large cell lymphoma
    • Bacteria
    • Biofilm
    • Breast implant
    • Capsulectomy
    • T cell

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