A Further Case Report from the United Kingdom of Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and a Reason to Avoid the Subpectoral Plane
Journal of Surgery
Volume 4, Issue 5, October 2016, Pages: 89-94
Received: Aug. 1, 2016;
Accepted: Aug. 11, 2016;
Published: Sep. 2, 2016
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James Donaldson Frame, Aesthetic Plastic Surgery, Anglia Ruskin University, Chelmsford, Essex, United Kingdom
Simon Smith, Broomfield Hospital, Chelmsford, United Kingdom
Dia Kamel, Broomfield Hospital, Chelmsford, United Kingdom
Breast Augmentation is only second to liposuction as the most commonly performed Aesthetic Surgery procedure in the United Kingdom with a “guestimated” 50,000 cases per annum. Silicone elastomer shells containing silicone gel implants have been used continuously for over 50 years in the UK. Recently Anaplastic Large Cell Lymphoma (BIA-ALCL) has been associated in women having breast implants with variants of a disease process that may remain intracapsular and resolved by removal of implant and total capsulectomy, or nodular and metastatic with proven risk of mortality. An MHRA ‘advisory notice’ merely confirms the views of the MHRA that breast augmentation is safe, nothing needs to be done for existing augmented patients and even if a women develops this condition it can be successfully treated. However there have been nine deaths from BIA-ALCL and actually what Surgeons urgently need is advice on best management protocol and encouragement for international collaboration and evidence based medicine. Diagnosis of BIA-ALCL is dependent upon awareness, correct diagnostic immune staining techniques and review by knowledgeable histopathologists. Recommendations on management of BIA-ALCL should follow the guidelines of Kim et al in 2015. It is important to collect data and outcomes on such patients. The use of submuscular plane for primary breast augmentation should be carefully reconsidered in ensuring safe and complete capsulectomy in the event of BIA-ALCL.
James Donaldson Frame,
A Further Case Report from the United Kingdom of Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and a Reason to Avoid the Subpectoral Plane, Journal of Surgery.
Vol. 4, No. 5,
2016, pp. 89-94.
Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
FDA Update on the safety of Silicone gel-Filled Breast Implants (2011). www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics
Maxwell GP, Gabriel A. The evolution of breast implants. Clin Plastic Surg. 2009; 36: 1-13.
Frame JD. Breast implants and Risk of Breast Cancer: A Meta-Analysis on Cohort Studies. Aesthetic Surg J. 2015; 35: 63-65.
FDA Breast Implant Consumer Handbook - 2004-Timeline of Breast Implant Activities. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm064242.htm.
Rupani A, Frame JD, Kamel D. Lymphomas Associated with Breast Implants: A Review of the Literature. Aesthet Surg J. 2015; 35: 533-44.
Brody GS, Deapen D, Taylor C, et al. Anaplastic large cell lymphoma occurring in women with breast implants: Analysis of 173 cases. Plast Reconstr Surg. 2015; 135: 695-705.
Parthasarathy M, Orrell J, Mortimer C, Ball L. Chemotherapy-resistant breast implant-associated anaplastic large cell lymphoma. BMJ Case Rep. 2013 Nov 27; 2013.
Hwang MJ, Brown H, Murrin R, Momtahan N, Sterne GD. Breast implant-associated anaplastic large cell lymphoma: a case report and literature review. Aesthetic Plast Surg. 2015; 39 (3): 391-5.
Talagas M, Uguen A, Charles-Petillon F, et al. Breast implant-associated anaplastic large-cell lymphoma can be a diagnostic challenge for pathologists. Acta Cytol. 2014; 58: 103-107.
Kadin ME, Deva A, Xu H, et al. Biomarkers Provide Clues to Early Events in the Pathogenesis of Breast Implant-Associated Anaplastic large Cell Lymphoma. Aesthet Surg J. 2016; 36: 773-81.
Xu J, Wei S. Breast implant-associated anaplastic large cell lymphoma. Review of a distinct clinicopathologic entity. Arch Pathol Lab Med 2014; 138: 842-846.
Sørensen K, Murphy J, Lennard A, Wadehra V, Menon GKCollis N. Anaplastic large cell lymphoma in a reconstructed breast using a silicone implant: A UK case report. J Plast Reconstr Aesthet Surg. 2014; 67 (4): 561-563.
Keech JA Jr, Creech BJ. Anaplastic T-cell lymphoma in proximity to a saline-filled breast implant. Plast Reconstr Surg 1997; 100 (2): 554-555.
Kim B, Roth C, Chung KC, et al. Anaplastic large cell lymphoma and breast implants: a systematic review. Plast Reconstr Surg. 2011; 127 (6): 2141-2150.
Kim B, Roth C, Young VL, et al. Anaplastic large cell lymphoma and breast implants: results from a structured
expert consultation process. Plast Reconstr Surg. 2011; 128 (3): 629-639.
Wu D, Allen CT, Fromm JR. Flow Cytometry of ALK-Negative Anaplastic Large Cell Lymphoma of Breast Implant-Associated Effusion and Capsular Tissue. Cytometry Part B (Clinical Cytometry); 88B: 58-63.
Miranda RN, Aladily TN, Prince HM, et al. Breast implant-associated anaplastic large-cell lymphoma: long- term follow-up of 60 patients. J Clin Oncol. 2014; 32 (2): 114-120.
Thompson PA, Prince HM. Breast implant-associated anaplastic large cell lymphoma: a systematic review of the literature and mini-meta analysis. Curr Hematol Malig Rep. 2013; 8 (3): 196-210.
Li S, Lee AK. Silicone implant and primary breast ALK1-negative anaplastic large cell lymphoma, fact or fiction? Int J Clin Exp Pathol. 2010; 3: 117-127.