Breast implant-associated anaplastic large cell lymphoma incidence: Determining an accurate risk Journal Article
| Authors: | Nelson, J. A.; Dabic, S.; Mehrara, B. J.; Cordeiro, P. G.; Disa, J. J.; Pusic, A. L.; Matros, E.; Dayan, J. H.; Allen, R. J. Jr; Coriddi, M.; Polanco, T. O.; Shamsunder, M. G.; Wiser, I.; Morrow, M.; Dogan, A.; Cavalli, M. R.; Encarnacion, E.; Lee, M. E.; McCarthy, C. M. |
| Article Title: | Breast implant-associated anaplastic large cell lymphoma incidence: Determining an accurate risk |
| Abstract: | OBJECTIVE: This study sought to estimate the incidence and incidence rate of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) at a high-volume single institution, which enables vigorous long-term follow-up and implant tracking for more accurate estimates. SUMMARY BACKGROUND DATA: The reported incidence of BIA-ALCL is highly variable, ranging from 1 in 355 to 1 in 30,000 patients, demonstrating a need for more accurate estimates. METHODS: All patients who underwent implant-based breast reconstruction from 1991 to 2017 were retrospectively identified. The incidence and incidence rate of BIA-ALCL were estimated per patient and per implant. A time-to-event analysis was performed using the Kaplan-Meier estimator and life table. RESULTS: During the 26-year study period, 9373 patients underwent reconstruction with 16,065 implants, of which 9589 (59.7%) were textured. Eleven patients were diagnosed with BIA-ALCL, all of whom had a history of textured implants. The overall incidence of BIA-ALCL was 1.79 per 1000 patients (1 in 559) with textured implants and 1.15 per 1000 textured implants (1 in 871), with a median time to diagnosis of 10.3 years (range, 6.4-15.5 yrs). Time-to-event analysis demonstrated a BIA-ALCL cumulative incidence of 0 at up to 6 years, increasing to 4.4 per 1000 patients at 10 to 12 years and 9.4 per 1000 patients at 14 to 16 years, although a sensitivity analysis showed loss to follow-up may have skewed these estimates. CONCLUSIONS: BIA-ALCL incidence and incidence rates may be higher than previous epidemiological estimates, with incidence increasing over time, particularly in patients exposed to textured implants for longer than 10 years. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. |
| Keywords: | middle aged; retrospective studies; united states; follow up; follow-up studies; incidence; risk factors; breast neoplasms; breast reconstruction; mammaplasty; retrospective study; risk factor; risk assessment; postoperative complication; postoperative complications; questionnaire; breast tumor; forecasting; breast endoprosthesis; breast implants; adverse event; lymphoma, large-cell, anaplastic; anaplastic large cell lymphoma; procedures; humans; human; female; adverse device effect; surveys and questionnaires |
| Journal Title: | Annals of Surgery |
| Volume: | 272 |
| Issue: | 3 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2020-09-01 |
| Start Page: | 403 |
| End Page: | 409 |
| Language: | English |
| DOI: | 10.1097/sla.0000000000004179 |
| PUBMED: | 32694446 |
| PROVIDER: | scopus |
| PMCID: | PMC8336676 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 April 2021 -- Source: Scopus |
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