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Title: | Breast implant-associated anaplastic large cell lymphoma |
Epworth Authors: | Prince, Miles |
Other Authors: | Rastogi, P. Deva, Anand |
Keywords: | Breast Implant-Associated Anaplastic Large Cell Lymphoma BIA-ALCL Malignancy T Lymphocytes Textured Breast Implants Evaluate Existing Theories Epidemiology Pathogenesis Clinical Evaluation Management Pathogenic Theory Gram-Negative Bacteria Host Genetics JAK/STAT Delayed Seroma Capsular Mass Systemic Disease Liquid Tumor Model Solid Tumor Classification Complete Capsulectomy Implant Removal Localised Disease Advanced Disease Chemotherapy Combination Anthracycline-Based Radiotherapy Antibody Drug Conjugate Brentuximab Vedotin Gram-Negative Biofilm Genetic Mutations Putative Infectious Cause Lymphomagensis Immunological Modulation Cancer Services Clinical Institute, Epworth HealthCare, Victoria, Australia |
Issue Date: | Oct-2018 |
Publisher: | Springer |
Citation: | Curr Hematol Malig Rep. 2018 Oct 22 |
Abstract: | PURPOSE OF REVIEW: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently recognised malignancy of T lymphocytes exclusively associated with textured breast implants. This review aims to evaluate existing theories regarding the epidemiology, pathogenesis, clinical evaluation and management of the disease. RECENT FINDINGS: The true incidence of BIA-ALCL is difficult to define. Prevailing pathogenic theories recognise the interplay between textured implants, Gram-negative bacteria, host genetics (e.g. JAK/STAT, p53) and time. Patients typically present with a delayed seroma and less commonly with a capsular mass or systemic disease at an average of 8-10 years after implantation. BIA-ALCL staging has evolved from a "liquid tumour" model to a "solid tumour" classification. For localised disease, surgery involving complete capsulectomy and implant removal is the cornerstone of treatment. For more advanced disease, treatment includes surgery followed by chemotherapy (combination anthracycline-based), radiotherapy and the antibody drug conjugate (brentuximab vedotin). The interplay between the Gram-negative biofilm, implant texturing, genetic mutations and time has been implicated in pathogenesis of BIA-ALCL. The identification of a putative infectious cause is not unique to lymphomagenesis. Future research, investigating BIA-ALCL genetic mutations and immunological modulation with Gram-negative biofilm in BIA-ALCL models is warranted. |
URI: | http://hdl.handle.net/11434/1559 |
DOI: | 10.1007/s11899-018-0478-2 |
PubMed URL: | https://www.ncbi.nlm.nih.gov/pubmed/30345474 |
ISSN: | 1558-822X 1558-8211 |
Journal Title: | Current Hematologic Malignancy Reports |
Type: | Journal Article |
Affiliated Organisations: | Department of Plastic, Reconstructive & Maxillofacial Surgery - Macquarie University, Sydney, New South Wales, Australia Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia Epworth HealthCare, VIC, Australia |
Type of Clinical Study or Trial: | Review |
Appears in Collections: | Cancer Services |
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