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
LAUNCH OF THE BREAST SCREENING AFTER RADIOTHERAPY DATASET - AN ENGLAND WIDE INITIATIVE TO IMPROVE SCREENING FOR BREAST CANCER IN 9,000 WOMEN AT HIGH RISK FOLLOWING RADIOTHERAPY TO BREAST TISSUE UNDER AGE 36 Radford, J; Howell, S; Vaughan, K; Goode, V; Worthington, D; Yates-Bolton, N; Payne, E; Jenkins, J; Sibbering, M; Swerdlow, A; Cowan, R (2016-10)
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 ...