Breast Implant-associated Anaplastic Large Cell Lymphoma Research Articles

Implant Malposition in Prepectoral Breast Reconstruction: Experience with Natrelle® Cohesive Implants over 6.5 Years

Implant malposition has been reported to be a common reason for revision surgery after implant-based breast reconstruction (IBR). With the recent increase in the use of smooth implants due to concerns for breast implant-associated anaplastic large-cell lymphoma with textured implants, we compared and reported the rates of malposition in prepectoral IBR and identified risk factors. A retrospective review of patients who underwent prepectoral IBR with Natrelle® (Allergan, Inc., Irvine, CA) implants at our institution between January 2014 and May 2020 was performed. Clinical characteristics, implant types, and the rate of malposition, defined as implant flipping or rotation, were recorded. Univariate and multivariable time-to-event analyses using the Cox proportional-hazards model were performed to identify predictors of malposition. Three hundred seventy-five patients (660 breasts) were included. Four hundred forty-one (66.8%) breasts had smooth round implants whereas 219 (33.2%) had textured anatomical devices. Malposition requiring either a manual correction or surgical intervention occurred in 26 (5.9%) smooth round implants versus 3 (1.4%) textured anatomical. Multivariable analysis showed that having a smooth round implant (aHR: 7.19, 95% CI: [2.04 - 25.4]) and an increase in implant volume (aHR: 1.003, 95% CI: [1.001 - 1.006]) were associated with having a malposition requiring intervention. Among smooth round implants; INSPIRA® Cohesive implants were more likely to result in a malposition requiring intervention (p<0.0001) compared to other smooth round implants. Overall, malposition requiring intervention occurred in 5.9% of smooth round implants and 1.4% of textured anatomical implants. Statistical analysis demonstrates that smooth round implants and an increase in implant volume both are associated with a malposition requiring intervention.

Breast-implant-associated anaplastic large-cell lymphoma

Breast-implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is an uncommon, recently recognized disease that seems to occur only in relation with implants with textured surfaces. Most cases present with late-onset peri-implant effusion or fluid collections that develop more than 12 months after insertion of the implant. The diagnosis is reached by cytological analysis of fluid samples obtained by ultrasound-guided fine-needle aspiration. These patients usually have a good prognosis after surgical removal of the implant. A small percentage of patients present with a nodule or mass adjacent to the implant that usually develops late. In these cases, the diagnosis is reached by the histological analysis of core-needle biopsy specimens. These patients have a worse prognosis and require a combination of surgery and systemic chemotherapy. The main immunophenotypic characteristics of this lymphoma are intense expression of CD30 and a lack of expression of anaplastic lymphoma kinase (ALK). Here we present a case of BIA-ALCL in a patient with implants with a textured surface that presented with peri-implant effusion and incipient formation of a millimetric nodule and was treated with removal of the implant and bilateral capsulectomy. It is important to point out that the disease requires multidisciplinary management and that the Spanish Agency of Medicines and Medical Devices (AEMPS) should be notified when the diagnosis is confirmed.

An Updated Approach and Understanding of Breast Implant-Associated Anaplastic Large Cell Lymphoma.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare subtype of T-cell non-Hodgkin lymphoma that is usually localized to the fluid and capsule surrounding a breast implant. There have only been <1,000 cases and 36 deaths reported to date and the average patient presents 7 to 10 years following initial breast implant placement. Most patients present with delayed seromas, a breast mass, capsular abnormalities, lymphadenopathy, or cutaneous masses. Unlike other forms of non-Hodgkin lymphoma, most cases are cured with surgery alone. The challenge of BIA-ALCL surrounds its rarity-in regard to both its diagnosis as well as the limited available data to guide therapy for more advanced cases. Careful pathology evaluation to analyze both the fluid surrounding the capsule and the capsule itself is critical. Studies to identify which patients are at greater risk of development of this rare entity are ongoing.

Case report of breast implant-associated anaplastic large cell lymphoma and a call for increased awareness

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare but serious complication of breast implants. The incidence of BIA-ALCL varies between 1:9121 and 1:13745, and a recent meta-analysis found that countries where specific monitoring measures have been implemented have higher rates of cases. While a significant complication, there is no current evidence to support surgical risk management strategies to prevent BIA-ALCL. Many countries have adopted a model of surveillance, and in Australia the Therapeutic Goods Administration has endorsed data collection through the Australian Breast Device Registry (ABDR). We present a case of a 67-year-old woman who presented to her GP with 2 months of left breast swelling, on a background of a left breast implant in 2004. MRI of the left breast demonstrated a large peri-implant fluid collection, and cytology confirmed BIA-ALCL, CD30-positive and ALK-negative. She underwent a capsulectomy and final histology demonstrated a Breast Implant-Associated Anaplastic Large Cell Lymphoma with focal penetration of neoplastic cells beyond the capsule and into pericapsular fat (stage T4). While development of registries and national guidelines has ensured the safeguarding of health outcomes for patients moving forward, there is still a concern for women with pre-existing breast implants who are unaware of the risk of BIA-ALCL. This case highlights the importance of raising awareness and providing support to primary health care providers to ensure their patients are given the necessary information to avoid this rare, but serious complication.

Silicone-induced granuloma of breast implant capsule mistaken for breast implant-associated anaplastic large cell lymphoma

For patients with breast implants who present with an isolated seroma, capsular contracture, or peri-implant mass, clinicians must rule out breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). As non-malignant silicone-induced granuloma of breast implant capsule (SIGBIC) may mimic BIA-ALCL, particular care must be exercised to prevent misdiagnosis. In this report, we describe three cases of SIGBIC misdiagnosed as BIA-ALCL. In each of these cases, a preoperative evaluation including breast magnetic resonance imaging and physical examination, as well as the fact that a textured silicone implant was used in the patients, indicated a high probability of malignancy. In all three cases, however, an explorative operation and pathologic results revealed foreign body granulomas without malignant features. While it is critical that potential cases of BIA-ALCL be diagnosed and treated quickly, hasty judgments may lead to misdiagnosis and severe emotional distress in patients. Increased awareness of SIGBIC, specifically its mimicry of BIA-ALCL, may be helpful to avoid these outcomes.

Silicone-induced granuloma of breast implant capsule mistaken for breast implant-associated anaplastic large cell lymphoma

For patients with breast implants who present with an isolated seroma, capsular contracture, or peri-implant mass, clinicians must rule out breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). As non-malignant silicone-induced granuloma of breast implant capsule (SIGBIC) may mimic BIA-ALCL, particular care must be exercised to prevent misdiagnosis. In this report, we describe three cases of SIGBIC misdiagnosed as BIA-ALCL. In each of these cases, a preoperative evaluation including breast magnetic resonance imaging and physical examination, as well as the fact that a textured silicone implant was used in the patients, indicated a high probability of malignancy. In all three cases, however, an explorative operation and pathologic results revealed foreign body granulomas without malignant features. While it is critical that potential cases of BIA-ALCL be diagnosed and treated quickly, hasty judgments may lead to misdiagnosis and severe emotional distress in patients. Increased awareness of SIGBIC, specifically its mimicry of BIA-ALCL, may be helpful to avoid these outcomes.

Assessing Long-Term Outcomes in Breast Implant Illness: The Missing Link? A Systematic Review.

The purpose of this special topic article is to explore the current state of outcomes-based literature related to breast implant illness and summarize the key understandings that emerge from the summation of existing studies. While implanted silicone devices are some of the most ubiquitous products in modern medicine, the safety of silicone breast implants has long remained under scientific scrutiny. In the era of social media and with breast implants once again under public scrutiny with the recent connection of texture silicone implants to breast implant-associated anaplastic large-cell lymphoma, the borders between breast implant illness and other implant-related diseases are becoming clouded in the public eye. The surgical management options for breast implant illness range from simple implant explantation alone to complete en bloc capsulectomies, or even secondary exploratory operations for additional capsulectomy in persistently symptomatic patients. In this review of outcomes-based studies related to breast implant illness, the authors found that a subset of patients improves with surgical intervention but limited evidence to inform most current surgical management practices. Further, the nature of this illness renders it difficult to study. A carefully designed, large, prospective, outcomes-based study is still required if an evidence-based and sound treatment approach for this condition is to be established.

Current Progress in Breast Implant-Associated Anaplastic Large Cell Lymphoma.

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.

Perceptions and attitudes toward unusual complications following breast implant surgeries among Saudi female patients: How knowledgeable are our patients?

Background:The number of breast implant-related procedures has rapidly increased. Given the current increase in social media coverage and its influence on the decision to undergo breast implant surgeries, it is critical to identify patients’ misinformation about unusual complications related to breast implants. Therefore, the present study aimed to assess the perceptions and attitudes toward unusual complications related to breast implants among patients who underwent breast implant surgeries.Methods:In the present cross-sectional study, a questionnaire was distributed between April 2021 and May 2021 among patients who had undergone breast implant surgeries between 2016 and 2021 at King Saud University Medical City in Riyadh, Saudi Arabia. The 26-item questionnaire was distributed online to assess the participants’ perceptions about breast implant illness (BII), capsular contracture, and breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL). Data were analyzed using Statistical Package for the Social Sciences (SPSS), version 23.0.Results:In total, 106 patients who underwent breast implant surgeries were included in the present study (response rate: 73.6%). Their mean age was 43.68 ± 10.69 years. The reason for undergoing breast implant surgery was cosmetic in 41.5% of the participants and reconstructive in 58.5%. Moreover, 22.6%, 23.6%, and 24.5% of the participants had knowledge about BIA-ALCL, BII, and capsular contracture, respectively.Conclusions:The present findings indicate that it is important for plastic surgeons to discuss unusual complications related to breast implants with patients on a regular basis. Despite the obscurity of these complications, such discussions are important to provide best available information to patients.

Silicon breast implants’ texture affecting bacterial biofilm formation

Introduction/Objective. The most important etiologic factors for both, capsular contracture (CC) and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is subclinical infection, defined as a response of an organism on presence of biofilm on the implant surface. The aim of this research was to examine the possibility of biofilm formation of four different bacteria (Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, and Ralstonia picketti) on three differently textured silicone breast implants (Siltex, Mentor, pore size 70?150 ?m; MESMORsensitive, Polytech, pore size 50?900 ?m; and SilkSurface, Motiva pores 13 ?m) in vitro. Methods. Samples of silicone breast implant capsules (sized 1 ? 1 cm) were divided into three groups according to texture. After sterilization, 30 samples in every group were contaminated with 100 ?l of examined bacterial broth, followed by incubation which led to biofilm formation. For testing the capability of biofilm formation, modified technique with microtitar plates described by Stepanovic? was used. Results. All four examined bacteria (Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, and Ralstonia picketti) form more biofilm on implants with pore sizes 50?900 ?m compared to implants with pore size 70?150 ?m and those with 13 ?m. Statistical significance was found in biofilm formation on implants with pores 70?150 ?m compared to implants with pores 13 ?m. The only exception was P. aeuruginosa which did not show significant difference in biofilm formation on implants 70?150 ?m and 13 ?m. Conclusion. Silicone breast implants with micro and nanotexture should be chosen in order to prevent biofilm formation and possible consequent complications.

A Rationale for Micro-textured Breast Implant Augmentation.

BackgroundTextured breast implants have been used in aesthetic breast surgery to decrease rates of malposition and capsular contracture. Recent concerns regarding breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)’s link to textured devices have prompted many physicians to reevaluate their use.ObjectivesThe authors aimed to create an algorithm for when to use smooth vs micro-textured breast implants and provide their rationale for when micro-textured implants may be more beneficial.MethodsIn total, 133 patients received primary augmentations performed by a single surgeon from January 2018 to December 2020; 84 patients received smooth implants and 49 patients received micro-textured implants. All surgeries were performed in the dual plane using an inframammary incision. Implant-related complications and scar malposition were recorded and compared between groups.ResultsNo significant difference in the prevalence of implant-related complications was found (3.57% for smooth devices and 2.04% for micro-textured devices [P-value 0.621257; 95% CI −0.06100 to 0.007467]). There were no cases of BIA-ALCL. A comparison of scar malposition rates between the smooth and micro-textured groups also revealed no statistically significant difference (15.4% for smooth devices and 8.16% for micro-textured devices [P-value 0.226156; 95% CI −0.1200 to 0.007467]). Patients in the micro-textured group proportionately had more anatomical risk factors for malposition.ConclusionsMicro-textured breast implants continue to be a safe and effective choice for patients. Micro-textured implants show a trend toward decreased scar malposition, although not statistically significant. Patients at high risk for malposition with micro-textured breast implants give similar results to patients at average risk for malposition with smooth implants.Level of Evidence: 3

Causes of BIA-ALCL: a summary of the current state of knowledge

The reasons for the development of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) have recently been quite a popular topic. The main interest is among plastic surgeons, surgical oncologists, hematologists, and oncologists. Over the past decade, numerous scientific papers on this subject have been published. Potential etiopathogenetic factors include the type of implants, biofilm, inflammation, microtrauma, and genetic mutations. None of the above potential causes have been adequately proven by scientific evidence; anyway, they should not be considered separately, as they are likely to coexist. Further research and exchange of experience among doctors and scientists are necessary to determine the leading etiopathogenetic factor. Its emergence would contribute to the rise of the possibility of using effective preventive measures in patients undergoing breast implant surgery and perhaps even eliminating BIA-ALCL.

Cost and clinical benefit of imaging surveillance after treatment for breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)

Recent UK guidelines recommend that surveillance imaging should not be offered to patients who have undergone treatment for breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) unless clinically indicated. The aim of this study was to explore the evolving practice at a tertiary referral unit and quantify the direct economic costs (DEC) associated with post-treatment BIA-ALCL routine radiological surveillance prior to adoption of the guidelines. Eleven patients were treated for BIA-ALCL between 2015 and 2020. At a median follow-up of 38 months (IQR 12–47) there were no local or distant relapses. Two patients did not have any radiological surveillance and 1 had follow-up elsewhere. The remaining 8 patients had a combination of positron emission tomography/computed tomography (PET/CT) (n = 10), CT (n = 2), breast ultrasound (n = 6), mammogram (n = 4) and breast magnetic resonance imaging (MRI) (n = 1) as routine imaging follow-up not guided by clinical concerns. Total cost of imaging was £10,396 (€12,257) with a median cost of £1953 (€2304) per patient [IQR £526-2029 (€621-2394)]. This cost could have been saved based on current guidelines recommending no routine surveillance for asymptomatic patients.

Breast implant-associated anaplastic large-cell lymphoma - an evolution through the decades: citation analysis of the top fifty most cited articles.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is arecently discovered malignancy of T-cell type, correlated with the use of silicone breast implants. It has been theorized that the etiology may be linked to bacterial growth and long-term inflammation. The afflicted patient usually presents with breast swelling due to peri-implant fluid accumulation. Currently, the diagnosis is achieved by ultrasound, biopsy and testing for certain biomarkers. Following this, the treatment is achieved by complete surgical excision, or by capsulectomy and exchange with smoother surfaced implants. The aim of this study was to identify and report 50 most cited articles related to the field of BIA--ALCL. The Web of Science Citation Index was used to identify 325 articles pertaining to BIA-ALCL. The 50 most cited articles among these were included in this study. The title, author name, journal and year of publication, country and institute of origin, level of evidence (LoE), type of study (clinical or basic), and topic of study (pathophysiology, oncologic management, diagnosis, case report and case series) were recorded. This study includes articles from the period 1997-2018 with an average citation rate of 65.5. The majority of the top cited articles (36%; N = 18) were found to be case reports, followed by case series (18%; N = 9), systemic reviews (12%; N = 6) and studies focused on the pathophysiology (16%; N = 8), oncologic management (6%; N = 3), databases (6%; N = 3), diagnostics (4%; N = 2) and informed consent (2%; N=1). The articles were published across 30 journals and originated from 35 institutes. The United States was found to be the country of origin of most of the studies. While none of the articles achieved LoE 1, many were found to have LoE 4 (N = 11) or 5 (N = 19). Most of the articles (N=42), were clinical research studies. According to this citation analysis, alarge fraction of the existing high impact literature on BIA-ALCL is focused on disease monitoring. Through this study, we hope to present asimple educational tool to better appreciate the research in this relatively young field.

Breast implant-associated anaplastic large cell lymphoma: clinical follow-up and analysis of sequential pathologic specimens of untreated patients shows persistent or progressive disease

Breast implant-associated anaplastic large cell lymphoma (ALCL) is a distinctive type of T-cell lymphoma that arises around textured-surface breast implants. In a subset of patients, this disease can involve surrounding tissues, spread to regional lymph nodes, and rarely metastasize to distant sites. The aim of this study was to assess sequential pathologic specimens from patients with breast implant-associated ALCL to better understand the natural history of early-stage disease. To achieve this goal, we searched our files for patients who had breast implant-associated ALCL and who had undergone earlier surgical intervention with assessment of biopsy or cytologic specimens. We then focused on the patient subset in whom a definitive diagnosis was not established, and patients did not receive current standard-of-care therapy at that time. We identified a study group of ten patients with breast implant-associated ALCL in whom pathologic specimens were collected 0.5 to 4 years before a definitive diagnosis was established. A comparison of these serial biopsy specimens showed persistent disease without change in pathologic stage in three patients, progression in five patients, and persistence versus progression in two patients. Eventually, six patients underwent implant removal with complete capsulectomy and four underwent partial capsulectomy. Seven patients also received chemotherapy because of invasive disease, three of whom also received radiation therapy, two brentuximab vedotin after chemotherapy failure, and one allogeneic stem cell transplant. Eight patients achieved complete remission and two had partial remission after definitive therapy. At time of last follow-up, six patients were alive without disease, one had evidence of disease, one died of disease, and two patients died of unrelated cancers. In summary, this analysis of sequential specimens from patients with breast implant-associated ALCL suggests these neoplasms persist or progress over time if not treated with standard-of-care therapy.

Public Awareness of Breast Implant-associated Anaplastic Large Cell Lymphoma in Saudi Arabia.

Background:Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) was first reported in 1997. Since then, the number of reported cases has been increasing, and patients’ knowledge and perceptions about this condition are unclear. This study aimed to evaluate the public knowledge and perceptions toward BIA-ALCL and its association with cosmetic/reconstructive breast implants in Saudi Arabia.Methods:In this cross-sectional, online survey–based study, women aged 18–60 years in Saudi Arabia were the target population on social media platforms. Questions included data on demographics, experience of implants, and knowledge and concerns regarding BIA-ALCL.Results:A total of 543 women participated in this study, with a mean age of 34 years. Only 1.9% had breast implants due to cosmetic or reconstructive reasons, whereas 9.8% expressed their desire of having implants in the future. More than half (57.3%) of the respondents had never heard of BIA-ALCL in comparison with 21.7% who had an established background. After reading the highlights on BIA-ALCL, 60% of the women with breast implants still wanted to keep their implants and 42.5% of the ones who desired breast implants would still aim to have them. Almost all the sample stated that BIA-ALCL should be included in the written consent.Conclusions:Nearly half of Saudi women have not heard of BIA-ALCL, and report that it is an important part of the surgical consultation and informed consent. Our role as plastic surgeons is to raise the awareness of BIA-ALCL through social media and health care settings to maximize the safety of women with breast implants.

Use of flow cytometry and cytology to differentiate breast implant-associated anaplastic large cell lymphoma from reactive seromas in Brazilian patients.

The combination of cytology and multiparametric flow cytometry (MFC) may be useful in the diagnosis of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and may be a practical way to differentiate lymphoma from benign and reactive seromas. Although the Brazilian breast implant market is the second largest in the world, with several manufacturers and the almost exclusive use of textured implants, the occurrence of BIA-ALCL in Brazil is underreported. One hundred seventeen sequential collections of suspicious periprosthetic fluid (PF) from 105 Brazilian patients registered between March/2018 and March/2021 were evaluated by routine cytomorphology and flow cytometry. The combination of CD30, HLA-DR, and CD25 was used together with T and B lymphocyte and monocyte evaluation. The PF samples were divided into positive, acute reactive (neutrophilic exudate), or chronic reactive (macrophage or lymphocyte rich), and unavailable samples. Nine BIA-ALCL positive cases (7.7%) were identified, with typical morphology and increased FSC/SSC dispersion, bright expression of CD30, CD25 and HLA-DR, and absence or weakness of T-cell antigens (CD3, CD8, CD4, CD5, and CD7). Reactive samples were acute (n= 18, 15.4%) and chronic (n= 70, 59.8%). Twenty samples were excluded. The mean age of BIA-ALCL patients was 50 years (31-57 years) and 35 years in reactive patients (20-69 years). Use of MFC with a comprehensive antibody panel consisting of CD30 in conjunction with CD25 and HLA-DR can discriminate anaplastic cells of BIA-ALCL from lymphoid or neutrophilic reactive cells and should be considered in the initial evaluation of seroma.

Late seroma of the breast in association with COVID-19 infection: two case reports.

The SARS-CoV-2 pandemic is giving rise to a wide range of clinical manifestations, which can affect all organs and systems. Due to the enormous and constantly growing number of infected people, even the rarest complications will be observed in a very high number of patients. Late periprosthetic seroma of the breast has gained importance since the description of Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), but this entity is not the only cause. Among the causes of non-BIA-ALCL late seroma, we can include those of mechanical origin and those of non-mechanical origin. Within the latter, the common denominator is the triggering of an aberrant immune reaction that generates an inflammatory exudate from the periprosthetic capsule that gives rise to the seroma. We present two cases of late breast seroma as a manifestation of SARS-CoV-2 infection.Level of evidence: Level V, diagnostic study.

Current Challenges in Breast Implantation.

Breast implantation (BI) is the most common plastic surgery worldwide performed among women. Generally, BI is performed both in aesthetic and oncoplastic procedures. Recently, the prevalence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) or breast implant illness (BII) has aroused concerns. As a result, several countries, like Australia, Korea or the United Kingdom, introduced national registries dedicated to the safety and quality of BI surgeries. This narrative review aimed to focus on the clinical challenges, management and the current state of knowledge of BI. Both short and long-term outcomes of BI are determined by various alternatives and differences, which surgeons must consider during the planning and performing breast augmentation along with further complications or risk of reoperation. Proper preoperative decisions and aspects of surgical technique emerged to be equally important. The number of performed breast reconstructions is increasing, providing the finest aesthetic results and improving patient’s quality of life. Choice of prosthesis varies according to individual preferences and anatomical variables. A newly diagnosed cases of BIA-ALCL with lacking data on prevention, diagnosis, and treatment are placing it as a compelling medical challenge. Similarly, BII remains one of the most controversial subjects in reconstructive breast surgery due to unspecified diagnostic procedures, and recommendations.

Breast Implant Associated-Anaplastic Large-Cell Lymphoma (BIA-ALCL): Data Based on the Lymphoma Study Association (LYSA) Registry. Promising Results of Brentuximab Vedotin Combined with Cyclophosphamide, Doxorubicin and Prednisone (BV-CHP) As First Line Treatment for Patient Requiring Chemotherapy

Breast Implant Associated-Anaplastic Large-Cell Lymphoma (BIA-ALCL): Data Based on the Lymphoma Study Association (LYSA) Registry. Promising Results of Brentuximab Vedotin Combined with Cyclophosphamide, Doxorubicin and Prednisone (BV-CHP) As First Line Treatment for Patient Requiring Chemotherapy