Abstract
BackgroundA growing body of evidence indicates that breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is associated with the use of certain breast implants. Regional variations have been reported, and a genetic susceptibility has also been suggested. However, large variations in the ability to correctly diagnose BIA-ALCL and to further report and register cases exist between countries and may in part explain variations in the demography.Material and MethodsA survey was conducted by The European Association of Societies of Aesthetic Plastic Surgery E(A)SAPS and sent to 48 European countries. The primary aim was to identify the total number of confirmed cases of and deaths from BIA-ALCL in each country during four consecutive measurements over a two-year period.ResultsAn increase in BIA-ALCL cases during four repeated measurements from a total of 305 in April 2019 to 434 in November 2020 was reported by 23 of the 33 responding countries. A nearly 100-fold variation in the number of cases per million inhabitants was noted, where Netherlands had the highest rate (4.12) followed by Finland (1.99). Countries with the lowest reported rates were Austria (0.078), Romania (0.052) and Turkey (0.048).ConclusionThe current study displays a notable variation ßin the number of confirmed BIA-ALCL cases across Europe, even for countries with established breast implant registers. Variations in diagnosis and reporting systems may explain the differences, but the influence of genetic variations and the prevalence of high-risk implants cannot be excluded. Incomplete sales data along with medical tourism preclude an absolute risk assessment.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Highlights
Thirty-five Plastic and Aesthetic Surgery Societies are members of the European Association of Societies of Aesthetic Plastic Surgery (E(A)SAPS), initiated and founded by Ulrich Hinderer and Yann Levet in 2007
Background A growing body of evidence indicates that breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is associated with the use of certain breast implants
The current study identified 434 confirmed cases of BIAALCL and 14 deaths from BIA-ALCL in 33 participating European countries up to November 2020
Summary
Thirty-five Plastic and Aesthetic Surgery Societies are members of the European Association of Societies of Aesthetic Plastic Surgery (E(A)SAPS), initiated and founded by Ulrich Hinderer and Yann Levet in 2007. E(A)SAPS has identified 17 countries still without representation of plastic surgery in an independent professional society. A growing body of evidence indicates that BIA-ALCL is associated with the use of certain breast implants. The primary aim of the present study, conducted by the board of E(A)SAPS, was to compile European data on geographic distribution of confirmed cases and death rates of BIA-ALCL. Secondary aims were to evaluate the estimated prevalence of BIA-ALCL, reporting to national implant registers and identify countries that have implemented a ban on using textured breast implants. A growing body of evidence indicates that breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is associated with the use of certain breast implants. Material and Methods A survey was conducted by The European Association of Societies of Aesthetic Plastic Surgery E(A)SAPS and sent to 48 European countries. The primary aim was to identify the total number of confirmed cases of and deaths from BIA-ALCL in each country during four consecutive measurements over a two-year period
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