How I treat breast implant-associated anaplastic large cell lymphoma

Blood. 2018 Nov 1;132(18):1889-1898. doi: 10.1182/blood-2018-03-785972. Epub 2018 Sep 12.

Abstract

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently described form of T-cell non-Hodgkin lymphoma now formally recognized by the World Health Organization classification of lymphoid neoplasms. The disease most often presents with a delayed seroma around the breast implant, almost exclusively with a textured surface, and manifests with breast pain, swelling or asymmetry, capsular contracture, but can also present with a breast mass, and lymph node involvement. The prognosis of BIA-ALCL is favorable compared with many other subtypes of systemic T-cell lymphoma; however, unlike other non-Hodgkin lymphomas, complete surgical excision for localized disease is an important part of the management of these patients. In this paper, we share our recommendations for a multidisciplinary team approach to the diagnosis, workup, and treatment of BIA-ALCL in line with consensus guidelines by the National Comprehensive Cancer Network.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast / drug effects
  • Breast / pathology
  • Breast / surgery
  • Breast Implantation / adverse effects
  • Breast Implants / adverse effects*
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Etoposide / therapeutic use
  • Female
  • Humans
  • Lymphoma, Large-Cell, Anaplastic / etiology*
  • Lymphoma, Large-Cell, Anaplastic / pathology
  • Lymphoma, Large-Cell, Anaplastic / surgery
  • Lymphoma, Large-Cell, Anaplastic / therapy*
  • Neoplasm Staging
  • Prednisolone / therapeutic use
  • Prognosis
  • Vincristine / therapeutic use

Substances

  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Prednisolone

Supplementary concepts

  • CHOEP protocol
  • VAP-cyclo protocol