Nav: Home

Treatment guidelines for breast implant-associated lymphoma (BIA-ALCL)

March 12, 2019

The use of textured breast implants during augmentation or reconstructive surgery can slightly increase a patient's risk of developing Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a form of cancer that is distinct from other breast cancers. Now an article recently published in Aesthetic Surgery Journal formalizes the treatment strategy for this diagnosis, offering clear guidelines for plastic and oncologic surgeons. The National Comprehensive Cancer Network, U.S. Food and Drug Administration, and World Health Organization all recommend the surgical technique known as stepwise en bloc resection, which includes total capsulectomy (removing scar tissue around the implant), explantation (removal) of the implant, complete removal of any associated masses, and removal of any involved (proven by biopsy) or suspicious lymph nodes.

"With a complete oncologic resection of the lymphoma, the prognosis for BIA-ALCL is very good," says Sarah Tevis, MD, investigator at the University of Colorado Cancer Center and assistant professor of Surgery at the CU School of Medicine.

BIA-ALCL is diagnosed at a median 8-10 years after implantation of textured implants. However, Tevis suggests that any patient with fluid collection around the implant more than a year after surgery should be evaluated for lymphoma.

"At the point of diagnosis, it's important to completely treat the condition with definitive surgery," Tevis says, writing that, "Incomplete resections, partial capsulectomies, and positive margins are all associated with high rates of disease recurrence and, in rare cases, accelerated progression of disease."

Ongoing work seeks to define who is at highest risk for developing BIA-ALCL. For example, Tevis and colleagues recently published a small study in Aesthetic Surgery Journal showing that women who develop the condition are more likely than the general population to have a genetic difference leading to lack of a specific immune system protein called HLA-A26.

"We've seen that there may be a role for chronic inflammation in increasing the risk of implant-associated lymphoma. Now we see that changes in HLA genes and other genetic changes could predispose some women to develop breast implant-associated lymphoma," Tevis says, noting that more work is needed to explore this idea, and that surgeons or other professionals who encounter cases of BIA-ALCL can submit patient cases through the Plastic Surgery Foundation PROFILE Registry. This registry may help researchers identify risk factors for the condition and guide management of patients with the disease.

According to Tevis, the risk of implant-associated lymphoma is small, and the condition is most often surgically corrected, but, "we're seeing more and more of it, so we feel strongly it should be involved in the consent process for patients receiving these textured implants."

"Our hope," Tevis says, "is that by raising awareness of common presenting symptoms, proper treatment strategies and by continuing to build our understanding of the inner workings of BIA-ALCL, we can successfully treat the women who need treatment and, eventually, identify who is at highest risk for developing the disease."
-end-


University of Colorado Anschutz Medical Campus

Related Cancer Articles:

Radiotherapy for invasive breast cancer increases the risk of second primary lung cancer
East Asian female breast cancer patients receiving radiotherapy have a higher risk of developing second primary lung cancer.
Cancer genomics continued: Triple negative breast cancer and cancer immunotherapy
Continuing PLOS Medicine's special issue on cancer genomics, Christos Hatzis of Yale University, New Haven, Conn., USA and colleagues describe a new subtype of triple negative breast cancer that may be more amenable to treatment than other cases of this difficult-to-treat disease.
Metabolite that promotes cancer cell transformation and colorectal cancer spread identified
Osaka University researchers revealed that the metabolite D-2-hydroxyglurate (D-2HG) promotes epithelial-mesenchymal transition of colorectal cancer cells, leading them to develop features of lower adherence to neighboring cells, increased invasiveness, and greater likelihood of metastatic spread.
UH Cancer Center researcher finds new driver of an aggressive form of brain cancer
University of Hawai'i Cancer Center researchers have identified an essential driver of tumor cell invasion in glioblastoma, the most aggressive form of brain cancer that can occur at any age.
UH Cancer Center researchers develop algorithm to find precise cancer treatments
University of Hawai'i Cancer Center researchers developed a computational algorithm to analyze 'Big Data' obtained from tumor samples to better understand and treat cancer.
New analytical technology to quantify anti-cancer drugs inside cancer cells
University of Oklahoma researchers will apply a new analytical technology that could ultimately provide a powerful tool for improved treatment of cancer patients in Oklahoma and beyond.
Radiotherapy for lung cancer patients is linked to increased risk of non-cancer deaths
Researchers have found that treating patients who have early stage non-small cell lung cancer with a type of radiotherapy called stereotactic body radiation therapy is associated with a small but increased risk of death from causes other than cancer.
Cancer expert says public health and prevention measures are key to defeating cancer
Is investment in research to develop new treatments the best approach to controlling cancer?
UI Cancer Center, Governors State to address cancer disparities in south suburbs
The University of Illinois Cancer Center and Governors State University have received a joint four-year, $1.5 million grant from the National Cancer Institute to help both institutions conduct community-based research to reduce cancer-related health disparities in Chicago's south suburbs.
Leading cancer research organizations to host international cancer immunotherapy conference
The Cancer Research Institute, the Association for Cancer Immunotherapy, the European Academy of Tumor Immunology, and the American Association for Cancer Research will join forces to sponsor the first International Cancer Immunotherapy Conference at the Sheraton New York Times Square Hotel in New York, Sept.

Related Cancer Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Changing The World
What does it take to change the world for the better? This hour, TED speakers explore ideas on activism—what motivates it, why it matters, and how each of us can make a difference. Guests include civil rights activist Ruby Sales, labor leader and civil rights activist Dolores Huerta, author Jeremy Heimans, "craftivist" Sarah Corbett, and designer and futurist Angela Oguntala.
Now Playing: Science for the People

#520 A Closer Look at Objectivism
This week we broach the topic of Objectivism. We'll be speaking with Keith Lockitch, senior fellow at the Ayn Rand Institute, about the philosophy of Objectivism as it's taught through Ayn Rand's writings. Then we'll speak with Denise Cummins, cognitive scientist, author and fellow at the Association for Psychological Science, about the impact of Objectivist ideology on society. Related links: This is what happens when you take Ayn Rand seriously Another Critic Who Doesn’t Care What Rand Thought or Why She Thought It, Only That She’s Wrong Quote is from "A Companion to Ayn Rand"