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Title: Breast implant-associated anaplastic large cell lymphoma
Epworth Authors: Prince, Miles
Other Authors: Rastogi, P.
Deva, Anand
Keywords: Breast Implant-Associated Anaplastic Large Cell Lymphoma
T Lymphocytes
Textured Breast Implants
Evaluate Existing Theories
Clinical Evaluation
Pathogenic Theory
Gram-Negative Bacteria
Host Genetics
Delayed Seroma
Capsular Mass
Systemic Disease
Liquid Tumor Model
Solid Tumor Classification
Complete Capsulectomy
Implant Removal
Localised Disease
Advanced Disease
Combination Anthracycline-Based
Antibody Drug Conjugate
Brentuximab Vedotin
Gram-Negative Biofilm
Genetic Mutations
Putative Infectious Cause
Immunological Modulation
Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Oct-2018
Publisher: Springer
Citation: Curr Hematol Malig Rep. 2018 Oct 22
Abstract: PURPOSE OF REVIEW: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently recognised malignancy of T lymphocytes exclusively associated with textured breast implants. This review aims to evaluate existing theories regarding the epidemiology, pathogenesis, clinical evaluation and management of the disease. RECENT FINDINGS: The true incidence of BIA-ALCL is difficult to define. Prevailing pathogenic theories recognise the interplay between textured implants, Gram-negative bacteria, host genetics (e.g. JAK/STAT, p53) and time. Patients typically present with a delayed seroma and less commonly with a capsular mass or systemic disease at an average of 8-10 years after implantation. BIA-ALCL staging has evolved from a "liquid tumour" model to a "solid tumour" classification. For localised disease, surgery involving complete capsulectomy and implant removal is the cornerstone of treatment. For more advanced disease, treatment includes surgery followed by chemotherapy (combination anthracycline-based), radiotherapy and the antibody drug conjugate (brentuximab vedotin). The interplay between the Gram-negative biofilm, implant texturing, genetic mutations and time has been implicated in pathogenesis of BIA-ALCL. The identification of a putative infectious cause is not unique to lymphomagenesis. Future research, investigating BIA-ALCL genetic mutations and immunological modulation with Gram-negative biofilm in BIA-ALCL models is warranted.
DOI: 10.1007/s11899-018-0478-2
PubMed URL:
ISSN: 1558-822X
Journal Title: Current Hematologic Malignancy Reports
Type: Journal Article
Affiliated Organisations: Department of Plastic, Reconstructive & Maxillofacial Surgery - Macquarie University, Sydney, New South Wales, Australia
Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
Epworth HealthCare, VIC, Australia
Type of Clinical Study or Trial: Review
Appears in Collections:Cancer Services

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