Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Abstract

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a distinct type of T-cell lymphoma, developing around implants, that can occur 2 to 25 years (median 8 years) post-implantation. Most patients present with a swelling of the breast, which is usually associated with pain and fluid collecting around the implant. Less commonly, a lump in the breast and/or in the axilla can be present. A periprosthetic fluid collection (> 1 year post-implantation) should be investigated with ultrasound and fine needle aspiration. Immunohistochemistry confirms the diagnosis BIA-ALCL with CD30+ and ALK- expression. In most patients with disease localized to the periprosthetic fluid, surgery alone usually is curative. A total capsulectomy and bilateral implant removal should be performed. Before surgical intervention, international recommendations state that a PET-CT scan should be done to exclude disseminated disease. The international profile registry (www.thepsf.org/profile) collects all confirmed cases.