Focus On Medical Journal Articles About The Diagnosis And Treatment Of This Breast Implants Lymphoma Cancer Published In 2015
In January 2011 the U.S. Food and Drug Administration (FDA) first announced a possible association between breast implants and anaplastic large cell lymphoma (ALCL), which was likened to systemic ALCL and treated accordingly. See "Anaplastic Large Cell Lymphoma (ALCL) In Women with Breast Implants: Preliminary FDA Findings and Analyses".
Over the next couple of years there were some, but not many, medical journal articles reporting on findings about breast implant-associated ALCL (BIA-ALCL) having to do with diagnosis and treatment of this rare form of lymphoma.
For example, from the September 2013 edition of Current Hematologic Malignancy Reports, there was this article, "Breast implant-associated anaplastic large cell lymphoma: a systematic review of the literature and mini-meta analysis":
Breast implant-associated ALCL (BIA-ALCL) is a rare, but likely under-reported entity, which most commonly presents with an effusion developing between the breast implant and the host fibrous capsule that surrounds it. It has been described in association with breast implants used for post-cancer reconstructive surgery and when implanted for purely cosmetic reasons. Two different presentations are seen; presentation with an effusion alone +/- co-existing capsular contracture, without an associated mass, and presentation with a mass lesion +/- an effusion. These two presentations are associated with very different outcomes, with women presenting with effusion alone having an excellent long-term survival, even in the absence of specific therapy other than implant removal. In these women, no further therapy other than implant removal is likely necessary. In contrast, women presenting with a mass lesion have a higher rate of relapse and may require more aggressive therapy.
It seems that the medical literature about this breast implants lymphoma cancer situation grew considerably in 2015, perhaps reflecting a more rapidly developing understanding of the diagnosis and treatment aspects of BIA-ALCL.
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In February 2015 this article, "Breast Implant-associated Anaplastic Large Cell Lymphoma: Updated Results from a Structured Expert Consultation Process", was published in Plastic and Reconstructive Surgery-Global Open. From the Abstract for this article:
[A multidisciplinary panel] agreed that (1) this disease should be called "BIA-ALCL"; (2) late seromas occurring >1 year after breast implantation should be evaluated via ultrasound, and if a seroma is present, the fluid should be aspirated and sent for culture, cytology, flow cytometry, and cell block to an experienced hematopathologist; (3) surgical removal of the affected implant and capsule (as completely as possible) should occur, which is sufficient to eradicate capsule-confined BIA-ALCL; (4) surveillance should consist of clinical follow-up at least every 6 months for at least 5 years and breast ultrasound yearly for at least 2 years; and (5) BIA-ALCL is generally a biologically indolent disease with a good prognosis, unless it extends beyond the capsule and/or presents as a mass. They firmly disagreed with statements that chemotherapy and radiation therapy should be given to all patients with BIA-ALCL.
Next, in the March 2015 edition of Plastic and Reconstructive Surgery, came this report, "Anaplastic large cell lymphoma occurring in women with breast implants: analysis of 173 cases", which provided this information:
[Anaplastic large cell lymphoma (ALCL)] lesions first presented as late peri-implant seromas, a mass attached to the capsule, tumor erosion through the skin, in a regional node, or discovered during revision surgery. The clinical course varied widely from a single positive cytology result followed by apparent spontaneous resolution, to disseminated treatment-resistant tumor and death. There was no preference for saline or silicone fill or for cosmetic or reconstructive indications. Where implant history was known, the patient had received at least one textured-surface device.
In October 2015 Clinics in Plastic Surgery published "Coming of Age: Breast Implant-Associated Anaplastic Large Cell Lymphoma After 18 Years of Investigation", from which we get this excerpt:
Breast implant associated anaplastic large cell lymphoma (BIALCL) is a distinct clinical entity that can present in patients receiving either reconstructive or cosmetic breast implants. Presenting symptoms include onset of a delayed (>1 year after implantation) fluid collection, mass of the capsule, or lymphadenopathy. Treatment has progressed in recent years and most commonly includes implant removal and total resection of the tumor, including capsule, mass, and involved lymph nodes.
Given the developments medical researchers have made in understanding this breast implants lymphoma cancer situation, in March 2017 the FDA provided a summary of updated information it had collected in a new document, "Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)".
We continue to monitor the medical literature for articles about the diagnosis and treatment of BIA-ALCL as well as the various theories about how this rare form of lymphoma (blood cancer) develops in some women with breast implants.