American Association of Plastic Surgeons Consensus on Breast Implant-Associated Anaplastic Large-Cell Lymphoma

Authors

Mark W Clemens
Terence M Myckatyn
Arianna Di Napoli
Andrew L Feldman
Elaine S Jaffe
Cara L Haymaker
Steven M Horwitz
Kelly K Hunt
Marshall E Kadin
Colleen M McCarthy
Roberto N Miranda
H Miles Prince
Fabio Santanelli di Pompeo
Sari D Holmes
Linda G Phillips

Publication Date

9-1-2024

Journal

Plastic and Reconstructive Surgery

Abstract

BACKGROUND: In the absence of high-quality evidence, there is a need for guidelines and multidisciplinary consensus recommendations on breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL). The purpose of this expert consensus conference was to evaluate the existing evidence regarding the diagnosis and management of BIA-ALCL caused by textured implants. This article aims to provide evidence-based recommendations regarding the management and prevention of BIA-ALCL.

METHODS: A comprehensive search was conducted in the MEDLINE, Cochrane Library, and Embase databases, and supplemented by manual searches of relevant English-language articles and "related articles" sections. Studies focusing on breast surgery and lymphoma associated with breast implants were included for analysis. Meta-analyses were performed and reviewed by experts selected by the American Association of Plastic Surgeons using a Delphi consensus method.

RESULTS: A total of 840 articles published between January of 2011 and January of 2023 were initially identified and screened. The full text of 188 articles was assessed. An additional 43 articles were excluded for focus, and 145 articles were included in the synthesis of results, with 105 of them being case reports or case series. The analysis encompassed a comprehensive examination of the selected articles to determine the incidence, risk factors, clinical presentation, diagnostic approaches, and treatment modalities related to BIA-ALCL.

CONCLUSIONS: Plastic surgeons should be aware of the elevated risks by implant surface type, implement appropriate patient surveillance, and follow the recommendations outlined in this statement to ensure patient safety and optimize outcomes. Ongoing research on the pathogenesis, genetic drivers, and preventative and prophylactic measures for BIA-ALCL is crucial for improving patient care.

Keywords

Humans, Lymphoma, Large-Cell, Anaplastic, Breast Implants, Female, Breast Neoplasms, Breast Implantation, Consensus, United States, Societies, Medical, Risk Factors, Postoperative Complications

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