Complete surgical excision is essential for the management of patients with breast implant-associated anaplastic large-cell lymphoma Journal Article

Authors: Clemens, M. W.; Medeiros, L. J.; Butler, C. E.; Hunt, K. K.; Fanale, M. A.; Horwitz, S.; Weisenburger, D. D.; Liu, J.; Morgan, E. A.; Kanagal-Shamanna, R.; Parkash, V.; Ning, J.; Sohani, A. R.; Ferry, J. A.; Mehta-Shah, N; Dogan, A.; Liu, H.; Thormann, N.; DiNapoli, A.; Lade, S.; Piccolini, J.; Reyes, R.; Williams, T.; McCarthy, C. M.; Hanson, S. E.; Nastoupil, L. J.; Gaur, R.; Oki, Y.; Young, K. H.; Miranda, R. N.
Article Title: Complete surgical excision is essential for the management of patients with breast implant-associated anaplastic large-cell lymphoma
Abstract: Purpose. Breast implant-associated anaplastic large-cell lymphoma (BI-ALCL) is a rare type of T-cell lymphoma that arises around breast implants. The optimal management of this disease has not been established. The goal of this study is to evaluate the efficacy of different therapies used in patients with BI-ALCL to determine an optimal treatment approach. Patients and Methods In this study, we applied strict criteria to pathologic findings, assessed therapies used, and conducted a clinical follow-up of 87 patients with BI-ALCL, including 50 previously reported in the literature and 37 unreported. A Prentice, Williams, and Peterson model was used to assess the rate of events for each therapeutic intervention. Results. Themedian and mean follow-up timeswere 45 and 30 months, respectively (range, 3 to 217 months). The median overall survival (OS) time after diagnosis of BI-ALCL was 13 years, and the OS rate was 93% and 89% at 3 and 5 years, respectively. Patients with lymphoma confined by the fibrous capsule surrounding the implant had better event-free survival (EFS) and OS than did patients with lymphoma that had spread beyond the capsule (P = .03). Patients who underwent a complete surgical excision that consisted of total capsulectomywith breast implant removal had better OS(P = .022) and EFS(P = .014) than did patients who received partial capsulectomy, systemic chemotherapy, or radiation therapy. Conclusion. Surgical management with complete surgical excision is essential to achieve optimal EFS in patients with BI-ALCL. Copyright © 2016 American Society of Clinical Oncology. All rights reserved.
Journal Title: Journal of Clinical Oncology
Volume: 34
Issue: 2
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2016-01-10
Start Page: 160
End Page: 168
Language: English
DOI: 10.1200/jco.2015.63.3412
PROVIDER: scopus
PUBMED: 26628470
PMCID: PMC4872006
Notes: Article -- Export Date: 3 February 2016 -- Source: Scopus
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MSK Authors
  1. Steven M Horwitz
    344 Horwitz
  2. Ahmet Dogan
    162 Dogan
  3. Neha Mehta Shah
    17 Shah