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UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) on behalf of the Medicines and Healthcare products Regulatory Agency (MHRA) Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group (PRASEAG)
- Source :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 47(2)
- Publication Year :
- 2020
-
Abstract
- Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T cell Non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body. Diagnosis is usually made by cytological, immunohistochemical and immunophenotypic evaluation of the peri-implant fluid: pleomorphic lymphocytes are characteristically anaplastic lymphoma kinase (ALK) negative and strongly positive for CD30. BIA-ALCL is indolent in most patients but can progress rapidly. Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative. Late diagnosis may require more radical surgery and systemic therapies and although these are usually successful, poor outcomes and deaths have been reported. By adopting a structured approach, as suggested in these guidelines, early diagnosis and successful treatment will minimize the need for systemic treatments, reduce morbidity and the risk of poor outcomes. These guidelines provide an evidence-based and systematic framework for the assessment and treatment of patients with suspected or proven BIA-ALCL and are aimed at all clinicians involved in the care of people with breast implants.
- Subjects :
- medicine.medical_specialty
CD30
medicine.medical_treatment
Breast Implants
Mammaplasty
Antineoplastic Agents
Breast Neoplasms
030230 surgery
law.invention
03 medical and health sciences
0302 clinical medicine
law
hemic and lymphatic diseases
Image Processing, Computer-Assisted
Anaplastic lymphoma kinase
Medicine
Humans
Radical surgery
Surgery, Plastic
Anaplastic large-cell lymphoma
Societies, Medical
Neoplasm Staging
Radiotherapy
business.industry
General Medicine
medicine.disease
United Kingdom
3. Good health
Lymphoma
Surgery
Radiation therapy
Oncology
Effusion
030220 oncology & carcinogenesis
Breast implant
Practice Guidelines as Topic
Lymphoma, Large-Cell, Anaplastic
Female
Implant
Symptom Assessment
business
Subjects
Details
- ISSN :
- 15322157
- Volume :
- 47
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....01e94de833558fe224aa3b50f0857527