Breast implant associated anaplastic large cell lymphoma: The UK experience. Recommendations on its management and implications for informed consent.
MetadataShow full item record
BACKGROUND: Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare, Non-Hodgkin lymphoma arising in the capsule of breast implants. BIA-ALCL presents as a recurrent effusion and/or mass. Tumours exhibit CD30 expression and are negative for Anaplastic Lymphoma Kinase (ALK). We report the multi-disciplinary management of the UK series and how the stage of disease may be used to stratify treatment. METHODS: Between 2012 and 2016, 23 cases of BIA-ALCL were diagnosed in 15 regional centres throughout the UK. Data on breast implant surgeries, clinical features, treatment and follow-up were available for 18 patients. RESULTS: The mean lead-time from initial implant insertion to diagnosis was 10 years (range: 3-16). All cases were observed in patients with textured breast implants or expanders. Fifteen patients with breast implants presented with stage I disease (capsule confined), and were treated with implant removal and capsulectomy. One patient received adjuvant chest-wall radiotherapy. Three patients presented with extra-capsular masses (stage IIA). In addition to explantation, capsulectomy and excision of the mass, all patients received neo-/adjuvant chemotherapy with CHOP as first line. One patient progressed on CHOP but achieved pathological complete response (pCR) with Brentuximab Vedotin. After a mean follow-up of 23 months (range: 1-56) all patients reported here remain disease-free. DISCUSSION: BIA-ALCL is a rare neoplasm with a good prognosis. Our data support the recommendation that stage I disease be managed with surgery alone. Adjuvant chemotherapy may be required for more invasive disease and our experience has shown the efficacy of Brentuximab as a second line treatment.
Version of record
Breast implant associated anaplastic large cell lymphoma (BIA-ALCL)
Breast implant effusion
Combined Modality Therapy
Lymphoma, Large-Cell, Anaplastic
License start date
Eur J Surg Oncol, 2017, 43 (8), pp. 1393 - 1401
Showing items related by title, author, creator and subject.
Partial breast radiotherapy after breast conservation surgery for early breast cancer: 5-year outcomes from the IMPORT LOW (CRUK/06/003) phase III randomised controlled trial Coles, C; Griffin, C; Kirby, A; Titley, J; Agrawal, R; Alhasso, A; Bhattacharya, I; Brunt, M; Ciurlionis, L; Chan, C; Donovan, E; Emson, M; Harnett, A; Haviland, J; Hopwood, P; Jefford, M; Kaggwa, R; Sawyer, E; Syndikus, I; Tsang, Y; Wheatley, D; Wilcox, M; Yarnold, J; Bliss, J
Do Patient-reported Outcome Measures Agree with Clinical and Photographic Assessments of Normal Tissue Effects after Breast Radiotherapy? The Experience of the Standardisation of Breast Radiotherapy (START) Trials in Early Breast Cancer. Haviland, JS; Hopwood, P; Mills, J; Sydenham, M; Bliss, JM; Yarnold, JR (2016-06)In radiotherapy trials, normal tissue effects (NTE) are important end points and it is pertinent to ask whether patient-reported outcome measures (PROMs) could replace clinical and/or photographic assessments. Data from ...
Partial-breast radiotherapy after breast conservation surgery for patients with early breast cancer (UK IMPORT LOW trial): 5-year results from a multicentre, randomised, controlled, phase 3, non-inferiority trial. Coles, CE; Griffin, CL; Kirby, AM; Titley, J; Agrawal, RK; Alhasso, A; Bhattacharya, IS; Brunt, AM; Ciurlionis, L; Chan, C; Donovan, EM; Emson, MA; Harnett, AN; Haviland, JS; Hopwood, P; Jefford, ML; Kaggwa, R; Sawyer, EJ; Syndikus, I; Tsang, YM; Wheatley, DA; Wilcox, M; Yarnold, JR; Bliss, JM; IMPORT Trialists (2017-09-09)BACKGROUND: Local cancer relapse risk after breast conservation surgery followed by radiotherapy has fallen sharply in many countries, and is influenced by patient age and clinicopathological factors. We hypothesise that ...