Breast Reconstruction Following Breast Implant-Associated Anaplastic Large Cell Lymphoma.
Adult
Aged
Breast Implantation
/ adverse effects
Breast Implants
/ adverse effects
Breast Neoplasms
/ etiology
Cohort Studies
Device Removal
/ methods
Female
Humans
Lymphoma, Large-Cell, Anaplastic
/ etiology
Mammaplasty
/ methods
Mastectomy
/ methods
Middle Aged
Prognosis
Retrospective Studies
Risk Assessment
Tertiary Care Centers
Treatment Outcome
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
entrez:
1
3
2019
pubmed:
1
3
2019
medline:
4
4
2019
Statut:
ppublish
Résumé
Standard of care treatment of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) involves surgical resection with implant removal and complete capsulectomy. We report a case series of BIA-ALCL reconstruction with proposals for timing and technique selection. We retrospectively reviewed and prospectively enrolled all BIA-ALCL patients at 2 tertiary care centers and 1 private plastic surgery practice from 1998 to 2017. Demographics, treatment, reconstruction, pathology staging, patient satisfaction, and oncologic outcomes were reviewed. We treated 66 consecutive BIA-ALCL patients and 18 (27%) received reconstruction. Seven patients (39%) received immediate reconstruction, and 11 (61%) received delayed reconstruction. Disease stage at presentation was IA (T1N0M0 disease confined to effusion or a layer on luminal side of capsule with no lymph node involvement and no distant spread) in 56%, IB in 17%, IC (T3N0M0 cell aggregates or sheets infiltrating the capsule, no lymph node involvement and no distant spread) in 6%, IIA (T4N0M0 lymphoma infiltrating beyond the capsule, no lymph node involvement and no distant spread) in 11%, and III in 11%. Types of reconstruction included smooth implants (72%), immediate mastopexy (11%), autologous flaps (11%), and fat grafting (6%). Outcomes included no surgical complications, but 1 patient progressed to widespread bone metastasis (6%); ultimately, all patients achieved complete remission. Ninety-four percent were satisfied/highly satisfied with reconstructions, whereas 6% were highly unsatisfied with immediate smooth implants. Breast reconstruction following BIA-ALCL management can be performed with acceptable complications if complete surgical ablation is possible. Immediate reconstruction is reserved for disease confined to capsule on preoperative positive emission tomography/computed tomography scan. Genetic predisposition and bilateral cases suggest that BIA-ALCL patients should not receive textured implants. Autologous options are preferable for implant adverse BIA-ALCL patients. Patients with extensive disease at presentation should be considered for 6- to 12-month delayed reconstruction with interval positive emission tomography/computed tomography evaluation.
Sections du résumé
BACKGROUND
Standard of care treatment of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) involves surgical resection with implant removal and complete capsulectomy. We report a case series of BIA-ALCL reconstruction with proposals for timing and technique selection.
METHODS
We retrospectively reviewed and prospectively enrolled all BIA-ALCL patients at 2 tertiary care centers and 1 private plastic surgery practice from 1998 to 2017. Demographics, treatment, reconstruction, pathology staging, patient satisfaction, and oncologic outcomes were reviewed.
RESULTS
We treated 66 consecutive BIA-ALCL patients and 18 (27%) received reconstruction. Seven patients (39%) received immediate reconstruction, and 11 (61%) received delayed reconstruction. Disease stage at presentation was IA (T1N0M0 disease confined to effusion or a layer on luminal side of capsule with no lymph node involvement and no distant spread) in 56%, IB in 17%, IC (T3N0M0 cell aggregates or sheets infiltrating the capsule, no lymph node involvement and no distant spread) in 6%, IIA (T4N0M0 lymphoma infiltrating beyond the capsule, no lymph node involvement and no distant spread) in 11%, and III in 11%. Types of reconstruction included smooth implants (72%), immediate mastopexy (11%), autologous flaps (11%), and fat grafting (6%). Outcomes included no surgical complications, but 1 patient progressed to widespread bone metastasis (6%); ultimately, all patients achieved complete remission. Ninety-four percent were satisfied/highly satisfied with reconstructions, whereas 6% were highly unsatisfied with immediate smooth implants.
CONCLUSIONS
Breast reconstruction following BIA-ALCL management can be performed with acceptable complications if complete surgical ablation is possible. Immediate reconstruction is reserved for disease confined to capsule on preoperative positive emission tomography/computed tomography scan. Genetic predisposition and bilateral cases suggest that BIA-ALCL patients should not receive textured implants. Autologous options are preferable for implant adverse BIA-ALCL patients. Patients with extensive disease at presentation should be considered for 6- to 12-month delayed reconstruction with interval positive emission tomography/computed tomography evaluation.
Identifiants
pubmed: 30817556
doi: 10.1097/PRS.0000000000005569
pii: 00006534-201903001-00009
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
51S-58SRéférences
Clemens MW, Miranda RNComing of age: breast implant-associated anaplastic large cell lymphoma after 18 years of investigation. Clin Plast Surg. 2015;42:605–613.
Keech JA Jr, Creech BJAnaplastic T-cell lymphoma in proximity to a saline-filled breast implant. Plast Reconstr Surg. 1997;100:554–555.
Clemens MW, Nava MB, Rocco N, et al.Understanding rare adverse sequelae of breast implants: anaplastic large-cell lymphoma, late seromas, and double capsules. Gland Surg. 2017;6:169–184.
Leberfinger AN, Behar BJ, Williams NC, et al.Breast implant-associated anaplastic large cell lymphoma: a systematic review. JAMA Surg. 2017;152:1161–1168.
de Boer M, van Leeuwen FE, Hauptmann M, et al.Breast implants and the risk of anaplastic large-cell lymphoma in the breast. JAMA Oncol. 2018;4:335–341.
Swerdlow SH, Campo E, Pileri SA, et al.The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127:2375–2390.
de Jong D, Vasmel WL, de Boer JP, et al.Anaplastic large-cell lymphoma in women with breast implants. JAMA. 2008;300:2030–2035.
Brody GS, Deapen D, Taylor CR, et al.Anaplastic large cell lymphoma occurring in women with breast implants: analysis of 173 cases. Plast Reconstr Surg. 2015;135:695–705.
Srinivasa DR, Miranda RN, Kaura A, et al.Global adverse event reports of breast implant-associated ALCL: an international review of 40 government authority databases. Plast Reconstr Surg. 2017;139:1029–1039.
Campanale A, Boldrini R, Marletta M22 Cases of BIA-ALCL: awareness and outcome tracking from the Italian Ministry of Health. Plast Reconstr Surg. 2018;141:11e–19e.
Loch-Wilkinson A, Beath KJ, Knight RJW, et al.Breast implant-associated anaplastic large cell lymphoma in Australia and New Zealand: high-surface-area textured implants are associated with increased risk. Plast Reconstr Surg. 2017;140:645–654.
Johnson L, O’Donoghue JM, McLean N, et al.Breast implant associated anaplastic large cell lymphoma: the UK experience. Recommendations on its management and implications for informed consent. Eur J Surg Oncol. 2017;43:1393–1401.
Doren EL, Miranda RN, Selber JC, et al.U.S. epidemiology of breast implant-associated anaplastic large cell lymphoma. Plast Reconstr Surg. 2017;139:1042–1050.
Hu H, Jacombs A, Vickery K, et al.Chronic biofilm infection in breast implants is associated with an increased T-cell lymphocytic infiltrate: implications for breast implant-associated lymphoma. Plast Reconstr Surg. 2015;135:319–329.
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;36:773–781.
Bizjak M, Selmi C, Praprotnik S, et al.Silicone implants and lymphoma: the role of inflammation. J Autoimmun. 2015;65:64–73.
Horwitz SM, Ansell SM, Ai WZ, et al.NCCN Guidelines Insights: T-Cell Lymphomas, Version 2.2018. J Natl Compr Canc Netw. 2018;16:123–135.
Clemens MW, Medeiros LJ, Butler CE, et al.Complete surgical excision is essential for the management of patients with breast implant-associated anaplastic large-cell lymphoma. J Clin Oncol. 2016;34:160–168.
Cheson BD, Fisher RI, Barrington SF, et alAlliance, Australasian Leukaemia and Lymphoma Group; Eastern Cooperative Oncology Group; European Mantle Cell Lymphoma Consortium; Italian Lymphoma Foundation; European Organisation for Research; Treatment of Cancer/Dutch Hemato-Oncology Group; Grupo Español de Médula Ósea; German High-Grade Lymphoma Study Group; German Hodgkin’s Study Group; Japanese Lymphorra Study Group; Lymphoma Study Association; NCIC Clinical Trials Group; Nordic Lymphoma Study Group; Southwest Oncology Group; United Kingdom National Cancer Research Institute. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32:3059–3068.
Clemens MW, Horwitz SMNCCN consensus guidelines for the diagnosis and management of breast implant-associated anaplastic large cell lymphoma. Aesthet Surg J. 2017;37:285–289.
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;32:114–120.
Kim B, Roth C, Chung KC, et al.Anaplastic large cell lymphoma and breast implants: a systematic review. Plast Reconstr Surg. 2011;127:2141–2150.
De Silva IM, Teague JA, Blake WEBreast implant associated anaplastic large cell lymphoma: a case report and reconstructive option. J Plast Reconstr Aesthet Surg. 2013;66:1773–1776.
Blombery P, Thompson ER, Jones K, et al.Whole exome sequencing reveals activating JAK1 and STAT3 mutations in breast implant-associated anaplastic large cell lymphoma anaplastic large cell lymphoma. Haematologica. 2016;101:e387–e390.
Di Napoli A, Jain P, Duranti E, et al.Targeted next generation sequencing of breast implant-associated anaplastic large cell lymphoma reveals mutations in JAK/STAT signalling pathway genes, TP53 and DNMT3A. Br J Haematol. 2018;180:741–744.
Bautista-Quach MA, Nademanee A, Weisenburger DD, et al.Implant-associated primary anaplastic large-cell lymphoma with simultaneous involvement of bilateral breast capsules. Clin Breast Cancer. 2013;13:492–495.
Macadam SA, Bovill ES, Buchel EW, et al.Evidence-based medicine: autologous breast reconstruction. Plast Reconstr Surg. 2017;139:204e–229e.
Taylor CW, Horgan K, Dodwell DOncological aspects of breast reconstruction. Breast. 2005;14:118–130.
Clemens MW, Brody GS, Mahabir RC, et al.How to diagnose and treat breast implant-associated anaplastic large cell lymphoma. Plast Reconstr Surg. 2018;141:586e–599e.