Breast Implant-Associated Anaplastic Large Cell Lymphoma: Immediate or Delayed Implant Replacement?

Abstract

Introduction: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare and recently described type of peripheral T-cell lymphoma. Fewer than 550 cases have been reported worldwide. Although BIA-ALCL is usually indolent, early diagnosis and treatment have been shown to improve outcome. Case Description: This case report describes the management of a 50-year-old healthy Caucasian woman presenting with rapid painful enlargement of the left breast. Imaging revealed findings consistent with BIA-ALCL. This diagnosis was confirmed by fine needle aspiration cytology and subsequent pathological analysis. Bilateral removal of implants, complete left capsulectomy and immediate bilateral implant exchange were performed. Conclusion: No consensus currently exists regarding optimal time of implant exchange and management of the contralateral capsule. The immediate replacement with smooth implants was thoroughly discussed with the patient and endorsed by expert opinion, given complete removal of the disease. There was no sign of recurrence at 6 months. Close clinical and radiological visits are planned for the next years. Level of Evidence V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.