Anaplastic large cell lymphoma associated with breast prostheses

Abstract

Background In 2011 the Therapeutic Goods Administration (TGA) released a summary report 1 in response to concerns from the US Food and Drug Administration (FDA) review of anaplastic large cell lymphoma (ALCL) associated with breast prostheses. 2 The TGA has received notification of six cases 3 of ALCL associated with breast implants in the Australian population. However the rarity of breast ALCL in the setting of breast implants as well as the background population makes the association controversial. In excess of 30 cases of ALCL associated with breast implants have been published worldwide. 4 Both silicone and saline filled implants have been associated with this disease. 5 Case report We present the histopathological findings in a case of ALCL seen in our institution, including cytological, pathological and immunohistochemical findings. This 33-year-old woman presented with recurrent peri-prosthetic seroma. This case is compared and added to the current literature which is reviewed. Discussion While there is majority agreement of an increase association with breast implant and ALCL the causation in still debated. While it may be premature to include this in the consent process for breast implantation, the available evidence does not support the removal of non-complicated breast implants. Fluid accumulating around an implant more than 6 months after surgery should be sent for cytological evaluation. 6