Risk of Breast Implant–Associated Anaplastic Large Cell Lymphoma

To the Editor De Boer et al calculate a 1:6920 lifetime risk of breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) in Dutch patients. The authors report that 82% of affected patients had macrotextured implants and 45% of all implants sold in the Netherlands from 2010 through 2015 were macrotextured (P < .001). Despite this significant comparison, de Boer et al do not find an association between implant type and BIA-ALCL risk. The authors recognize that their study is limited by the fact that almost no smooth implants are inserted in the Netherlands.

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