Surgical management and long-term outcomes of BIA-ALCL: A multidisciplinary approach Journal Article
| Authors: | Vorstenbosch, J.; Ghione, P.; Plitas, G.; Horwitz, S.; Kim, M.; Cordeiro, P.; Nelson, J.; McCarthy, C. |
| Article Title: | Surgical management and long-term outcomes of BIA-ALCL: A multidisciplinary approach |
| Abstract: | Background: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a subtype of ALCL that arises as a seroma or a mass in the capsule surrounding textured breast implants. However, collections of cases usually come from large groups of institutions or countries, with different approaches regarding surgery and treatment. Here we describe a cohort of 18 cases undergoing implant removal and capsulectomy followed at Memorial Sloan Kettering Cancer Center (MSKCC). Patients and Methods: We retrospectively analyzed all the cases of women with breast implants undergoing implant removal and capsulectomy for BIA-ALCL at MSKCC from January 2011 to June 2020. Results: Median age at diagnosis was 57 (range 35–77) years following a median implant exposure of 11 (range 7–33) years. All known implants were macrotextured with the proprietary Biocell macrotexturing pattern from salt-loss technique. A total of 16 patients (89%) had implants placed for breast cancer reconstruction. Patients presented with clinically evident effusion in 78% of cases and a mass in 17% of cases, and 83% of patients presented with stage 1 BIA-ALCL. Patients were followed for a median of 43.4 months (SD 45 months) after diagnosis. There were no cases of recurrent ALCL. All patients remain disease free and no patients died of ALCL. Conclusions: In this cohort of patients with BIA-ALCL surgically treated and followed at a single institution, we confirm the importance of adequate surgery (bilateral implant removal and complete capsulectomy) in patients presenting with seroma-confined disease. This dataset reinforces high rates of progression-free and overall survival when diagnosis is identified and treatment performed in those with limited-stage disease. © Society of Surgical Oncology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
| Keywords: | adult; clinical article; controlled study; treatment response; aged; middle aged; cancer surgery; retrospective studies; cancer recurrence; cancer radiotherapy; cancer staging; flow cytometry; nuclear magnetic resonance imaging; follow up; antineoplastic agent; progression free survival; breast cancer; cohort analysis; practice guideline; breast neoplasms; breast reconstruction; retrospective study; rash; b cell lymphoma; adjuvant chemotherapy; breast tumor; fluorodeoxyglucose f 18; long term care; breast endoprosthesis; breast implants; neoadjuvant chemotherapy; seroma; breast surgery; lymphadenopathy; cytopathology; breast augmentation; breast implantation; lymphoma, large-cell, anaplastic; mastalgia; anaplastic large cell lymphoma; humans; human; female; article; multidisciplinary team; internal mammary lymph node; ductal breast carcinoma in situ; mskcc score; capsulectomy |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 31 |
| Issue: | 3 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2024-03-01 |
| Start Page: | 2032 |
| End Page: | 2040 |
| Language: | English |
| DOI: | 10.1245/s10434-023-14636-4 |
| PUBMED: | 38102324 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK authors: Colleen McCarthy -- Source: Scopus |
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