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Title: Breast implant-associated anaplastic large cell lymphoma in Australia: a longitudinal study of implant and other related risk factors.
Epworth Authors: Prince, Miles
Other Authors: Loch-Wilkinson, Anna
Beath, Kenneth
Magnusson, Mark
Cooter, Rodney
Shaw, Karen
French, James
Vickery, Karen
Deva, Anand
Keywords: Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)
Longitudinal Study
Implant-Specific Risk
Allergan Biocell Devices
Cosmetic Augmentation
Post-Breast Cancer Reconstruction
Weight Loss/Pregnancy
Textured Devices
T Cell Anaplastic NonHodgkin’s Lymphoma
Poisson Distribution
Confidence Intervals
Kaplan-Meier Estimate
R Language
Multi-Implant Exposure
Augmentation Mastopexy
Surface Area/Roughness
Survival Model
Single Textured implant Exposure
Odds Ratios
Iatrogenic Complications
Tissue Expansion
Epworth Centre for Immunotherapies and Snowdome Laboratories
Molecular Oncology and Cancer Immunology
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Nov-2019
Publisher: Oxford University Press
Citation: Aesthetic surgery journal, 40(8), 838–846.
Abstract: Background: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an emerging cancer that has been linked to the use of textured devices. The recent increase in number and frequency of cases has led to worldwide regulatory action. Objectives: The authors aimed to longitudinally study BIA-ALCL in Australia since the index case was first reported in 2007. Methods: Confirmed historical cases were collected and then prospectively analyzed from October 2015 to May 2019. Clinical and implant exposure data were determined and compared with company sales data for 4 devices to generate implant-specific risk. Results: A total 104 cases of BIA-ALCL were diagnosed in Australia with exposure to 149 unique breast implants. The mean age of patients was 48.2 years (range, 22.4-78.5 years). They had an average time from implantation to diagnosis of 6.8 years. A total 51.7% of implants utilized in this cohort were Allergan Biocell devices. The indication for implant usage was for primary cosmetic augmentation in 70%, post-breast cancer reconstruction in 23%, and following weight loss/pregnancy in 7%. The majority of women presented with early (stage 1) disease (87.5%). The risk for developing BIA-ALCL ranged from 1 in 1947 sales (95% confidence interval = 1199-3406) for Silimed Polyurethane devices to 1 in 36,730 (95% confidence interval = 12,568-178,107) for Siltex imprinted textured devices. Conclusions: Implants with higher surface area/texture seem to be more associated with BIA-ALCL in Australia. Recent regulatory action to suspend, cancel, or recall some of these higher risk devices is supported by these findings.
DOI: 10.1093/asj/sjz333
PubMed URL:
ISSN: 1090-820X
Journal Title: Aesthetic Surgery Journal
Type: Journal Article
Type of Clinical Study or Trial: Longitudinal Study
Appears in Collections:Cancer Services

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