Breast Implant-Associated Anaplastic Large Cell Lymphoma: What We Can Do.

Abstract

Although anaplastic large cell lymphoma (ALCL) associated with breast implants is a rare finding, it has recently become better recognized according to reports of between 62 and 100 cases worldwide, not all of them confirmed. In March 2014, I had the opportunity to attend a Scientific Advisory Panel on ALCL association with breast implants, convened by the RAND Corporation (a nonprofit, nonpartisan research organization)1 at its Arlington, Virginia, office. Commissioned by the Plastic Surgery Foundation (formerly Plastic Surgery Educational Foundation) and the Aesthetic Surgery Education and Research Foundation, the RAND Corporation had convened a similar panel in 2011 and released key findings of a review of published ALCL cases.2 The 2-day meeting in 2014 included 13 multidisciplinary experts reviewing the latest information on ALCL involving the breast in women with breast implants and updating recommendations for evaluation, treatment, and follow-up of women presenting with this disease. I do not wish to preempt the RAND Corporation’s own release of these proceedings, which are forthcoming. However, I will briefly summarize what we as plastic surgeons can do to appropriately manage patient discussions and care and to move forward with the investigation of breast implant–associated ALCL. Breast implant surgery, whether cosmetic or reconstructive, has perhaps received more attention from a patient education standpoint than any other procedure that plastic surgeons routinely perform. ALCL in the breast is extremely uncommon. According to the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute, approximately 3 in 100 million women receive this diagnosis each year in the United States. However, the data pertaining specifically to women with breast implants currently indicate a somewhat higher-than-expected incidence, suggesting that breast implant–associated ALCL is a real entity. Furthermore, the US Food and Drug Administration (FDA) reports that, while still under study, there appears to be … Neal R. Reisman, MD, JD, FACS, 6624 Fannin Street, Suite 2390, Houston, TX 77030, USA. E-mail: drreisman{at}hotmail.com