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Multidisciplinary protocol mandatory for early diagnosis, patient management in ALCL

For anaplastic large cell lymphoma associated with breast implants, researchers propose a multidisciplinary protocol for early diagnosis and patient management,

From 2012 to 2014, the researchers identified four breast implant-associated anaplastic large cell lymphoma (ALCL) cases.

Researchers conducted a retrospective study of all patients who underwent breast implant positioning to identify any misdiagnosed cases.

They identified 483 patients: 226 underwent reconstruction with latissimus dorsi flap and prosthesis, 115 had skin-sparing/nipple-sparing mastectomy and prosthesis, 117 underwent an expander/implant procedure, and 25 underwent breast augmentation.

Fifty-eight patients underwent implant replacement for capsular contracture, 15 had late-onset seroma, and four had both. Surgical revision was required for these 77 symptomatic patients.

Researchers did not identify any misdiagnosed cases upon a second evaluation of histologic specimens, but the researchers created a multidisciplinary protocol for suspected ALCL cases

In cases of periprosthetic effusion, ultrasound and cytologic examinations are performed and in cases of ALCL, the implant is removed and capsulectomy is performed.

Patients with disseminated disease detected using PET/CT scans of the body are referred to the oncology department.

Disclosure: The researchers report no relevant financial disclosures.