Breast Implant-Associated Anaplastic Large-Cell Lymphoma: Current Understanding and Recommendations for Management.

Autor:	St Cyr TL; Mayo Clinic School of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA., Pockaj BA; Division of General Surgery, Mayo Clinic Hospital, Phoenix, AZ, USA., Northfelt DW; Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, AZ, USA., Craig FE; Division of Hematopathology, Mayo Clinic Hospital, Phoenix, AZ, USA., Clemens MW; Department of Plastic Surgery, Division of Surgery, MD Anderson Cancer Center, Houston, TX, USA., Mahabir RC; Private Practice, Scottsdale, AZ, USA.
Jazyk:	angličtina
Zdroj:	Plastic surgery (Oakville, Ont.) [Plast Surg (Oakv)] 2020 May; Vol. 28 (2), pp. 117-126. Date of Electronic Publication: 2020 May 21.
DOI:	10.1177/2292550320925906
Abstrakt:	Worldwide, millions of women live with breast implants. Therefore, it is important that physicians be aware of an uncommon but possibly serious complication arising from breast implants: breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Breast implant-associated anaplastic large-cell lymphoma most commonly presents as a delayed fluid collection around a textured breast implant or as a mass in the capsule surrounding the implant. The exact pathogenesis of the disease remains unclear. The neoplastic cells of BIA-ALCL show strong uniform staining for CD30 and are consistently negative for activin receptor-like kinase 1. Patients with confirmed cases should be referred to a lymphoma specialist or breast medical oncologist for a complete oncologic evaluation before any surgical intervention. For disease confined to the fluid accumulation or capsule, or both, surgical removal of the implant and complete capsulectomy is the preferred treatment. Postoperative chemotherapy or radiation, or both, are not considered necessary for patients with limited-stage disease and are reserved for advanced disease stages. Generally, BIA-ALCL is a local disease that follows an indolent course and has an excellent prognosis. Although complete remission of disease has occurred in patients with BIA-ALCL, median overall survival is reduced. As of March 2018, approximately 529 unique, confirmed BIA-ALCL cases had been reported in 23 countries. To date, 16 patients have died from BIA-ALCL, and all had extracapsular involvement. The aim of this article is to summarize the diagnosis, evaluation, and management of BIA-ALCL, based on established guidelines, for all practitioners who may care for patients with breast implants. Competing Interests: Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Dr Clemens is the Chair and Dr Mahabir the Vice-Chair of the Breast Implant–Associated Anaplastic Large-Cell Lymphoma Committee for the American Society of Plastic Surgeons. (© 2020 The Author(s).)
Databáze:	MEDLINE
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