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."

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.
More Cancer News and Cancer Current Events

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

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...