Breast implant-associated anaplastic large cell lymphoma

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

Research output: Contribution to journalReview articleResearchpeer-review

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.

LanguageEnglish
Pages516-524
Number of pages9
JournalCurrent Hematologic Malignancy Reports
Volume13
Issue number6
DOIs
Publication statusPublished - 1 Dec 2018

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Anaplastic Large-Cell Lymphoma
Breast Implants
Biofilms
Seroma
Neoplasms
Mutation
Anthracyclines
Disease Management
Combination Drug Therapy
Gram-Negative Bacteria
Epidemiology
Radiotherapy
T-Lymphocytes
Antibodies
Incidence
Therapeutics
Pharmaceutical Preparations

Keywords

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

Cite this

Rastogi, P. ; Deva, A. K. ; Prince, H. Miles. / Breast implant-associated anaplastic large cell lymphoma. In: Current Hematologic Malignancy Reports. 2018 ; Vol. 13, No. 6. pp. 516-524.
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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.",
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Breast implant-associated anaplastic large cell lymphoma. / Rastogi, P.; Deva, A. K.; Prince, H. Miles.

In: Current Hematologic Malignancy Reports, Vol. 13, No. 6, 01.12.2018, p. 516-524.

Research output: Contribution to journalReview articleResearchpeer-review

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