Breast implants linked to NHL lymphoma
A systematic review has highlighted an association between breast implants and anaplastic large-cell lymphoma (ALCL), a rare and indolent form of Non-Hodgkin Lymphoma (NHL). A second paper reviewing evidence is expected within a few weeks.
Anaplastic large cell lymphoma and breast implants: a systematic review. Kim B, Roth C, Chung KC et al. Plastic Reconstruct Surg. Advance on-line publication (doi: 10.1097/PRS.0b013e3182172418.
The review was undertaken following growing concerns about a possible link between NHL and breast implants. In January 2011, a review conducted by the US Food and Drug Administration indicated a possible association with ALCL. Although this form of lymphoma is extremely rare, the FDA concluded that women with breast implants may have a very small but increased risk of developing this disease in the scar capsule adjacent to the implant. However, there remains uncertainty about the true cause of ALCL in women with breast implants.1
The current review identified 36 cases of NHL in patients with implants, of which 29 (86%) were ALCL. Typically, these cases were characterised by the presence of a seroma in the fibrous capsule that forms around the implant. However, many cases lacked detailed information. The authors concluded, on the basis of available data that there may be an association which warrants further evaluation.
Haematology Now comment
Historically, ALCL appears to comprise two subtypes: 1) systemic disease with lymphadenopathy and extranodal involvement and 2) primary cutaneous disease limited to the skin. The two subtypes also differ histologically. While this report suggests a possible association between this rare form of NHL and breast implants, there remain unanswered questions about which subtype of disease is indicated. In addition, the study is limited by possible inconsistencies in the interpretation of pathology findings and reporting of the condition.
Reference 1. U.S. Food and Drug Administration. Anaplastic Large Cell Lymphoma (ALCL) In Women with Breast Implants: Preliminary FDA Findings and Analyses. January 2011. Available from: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239996.htm Accessed 16 March 2011.