A potentially new subcategory of anaplastic large cell lymphoma shows an association with breast implants. Researchers have compiled evidence from the 71 cases published to date. The main characteristics of these lymphomas thus become more tangible.
Anaplastic large cell lymphoma (ALCL) is a malignant neoplasm belonging to the group of non-Hodgkin’s lymphomas. A potentially new subcategory of ALCL has recently received increased attention in the literature; it appears to have a link to breast implants (it is therefore called iALCL, i.e., “breast implant associated ALCL”). This is suspected not least because ALCL in the breast region has so far occurred almost exclusively in patients with implants.
71 cases viewed
Recently, researchers reviewed all 71 published iALCL case presentations. The purpose of the review was to gather the main risk factors and main characteristics of the subcategory. The following points came out:
- The average patient with iALCL is 50 years old.
- In most cases, the tumors show up in the fibrous capsule surrounding the implant. They therefore grow in the scar tissue around the implant. When serous fluid appears in the capsule, ALCL is a differential diagnosis that should be considered during cytologic or histologic workup.
- iALCL is a late complication: on average, tumors present ten years after surgery.
- The absolute risk is very low, ranging from 1:500,000 to 1:3,000,000 breast implant patients per year.
- Most cases are ALK-negative, yet survival prognosis is significantly better compared to other ALK-negative lymphomas.
How to approach?
Often, a capsulotomy alone is sufficient for treatment (removal of the implant and surrounding tissue), suggesting that the implants were the biological stimulus. An abnormal immune response of the body to the implant would be possible. However, there are also cases that require more extensive chemotherapy or radiotherapy. CD30-based therapeutics may also be a future option. Overall, no recommendation on therapy can be made due to the small number of cases.
Source: Ye X, et al: Anaplastic large cell lymphoma (ALCL) and breast implants: breaking down the evidence. Mutation Research/Reviews in Mutation Research 23 August 2014. DOI: 10.1016/j.mrrev.2014.08.002.
InFo ONCOLOGY & HEMATOLOGY 2014; 2(9): 5.
