Abstract
Background
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of T cell lymphoma associated with breast implants. Five hundred and twenty-one cases have been reported worldwide to date. The clinical presentation has two distinct subtypes: late seroma and, rarely, a distinct mass lesion. We wanted to determine the implications of this emerging disease on the current practice of breast surgeons in the United Kingdom (UK) and Ireland and whether they have changed their practice following growing reports of associations with BIA-ALCL in the literature.
Methods
An 11-question survey was sent to four associations in the UK and Ireland: Association of Breast Surgery (ABS); British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS); British Association of Aesthetic Plastic Surgeons (BAAPS); and the Irish Association of Plastic Surgeons (IAPS). It was advertised in newsletters and also emailed to a list of consultant members of BAPRAS.
Results
Seventy-two responses were from consultant surgeons throughout both the UK and Ireland. Ninety-seven percent of consultants discussed the risks and associations of breast implants and BIA-ALCL with their patients. Seventeen percent had a patient who was diagnosed with ALCL in their practice. Seventeen percent of consultants have already changed their practice, including a transition to using smooth implants or using micro- or nano-textured implants. A further 11% will consider changing their practice in the future depending on more information and recommendations from higher departments.
Conclusions
BIA-ALCL is likely to be caused by a complex interplay of factors, allowing for the variation in clinical presentation and disease progression. Our survey has already shown a growing knowledge amongst breast surgeons in the UK and Ireland as well as a switch in practice in less than a third of consultants already.
Level of Evidence: not ratable
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