Abstract
Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is an uncommon type of T-cell lymphoma. Although with a low incidence, the epidemiological data raised the biosafety and health concerns of breast reconstruction and breast augmentation for BIA-ALCL. Emerging evidence confirms that genetic features, bacterial contamination, chronic inflammation, and textured breast implant are the relevant factors leading to the development of BIA-ALCL. Almost all reported cases with a medical history involve breast implants with a textured surface, which reflects the role of implant surface characteristics in BIA-ALCL. With this review, we expect to highlight the most significant features on etiology, pathogenesis, diagnosis, and therapy of BIA-ALCL, as well as we review the physical characteristics of breast implants and their potential pathogenic effect and hopefully provide a foundation for optimal choice of type of implant with minimal morbidity.
Highlights
Over the past few decades, breast implants have been widely used worldwide for breast augmentation and breast reconstruction
Considering that most cases of BIA-anaplastic large cell lymphoma (ALCL) are diagnosed in patients with textured implants, it is implied that the texture or surface roughness of the implant is related to the pathogenesis of this uncommon disease
Laurent et al investigated that BIA-ALCL was a unique clinical entity consisting of two histological subtypes depended on clinical characteristics: in situ BIA-ALCL, the effusion around the implant, anaplastic cell proliferation confined to the fibrous capsule; infiltrative BIA-ALCL, the palpable mass penetrating adjacent tissue and sometimes resembling Hodgkin lymphoma [7]
Summary
Over the past few decades, breast implants have been widely used worldwide for breast augmentation and breast reconstruction. In 1997, Keech and Creech reported the first case of BIA-ALCL with silicone breast implants [1]. Emerging studies have reported more than 800 cases of this uncommon lymphoma disease in women with breast implants [2, 3]. In 2008, a case-control study in the Netherlands initially found the association between breast implants and ALCL [4]. The exact pathogenesis of BIA-ALCL remains relatively poorly understood. Considering that most cases of BIA-ALCL are diagnosed in patients with textured implants, it is implied that the texture or surface roughness of the implant is related to the pathogenesis of this uncommon disease. We expect to highlight the most significant features on etiology, pathogenesis, diagnosis, and therapy of BIA-ALCL as well as we review the physical characteristics. The comprehensive understanding of BIA-ALCL is critical for early recognition and timely surgical resection
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