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Complete Surgical Excision Is Essential for the Management of Patients With Breast Implant–Associated Anaplastic Large-Cell Lymphoma
- Source :
- Journal of Clinical Oncology. 34:160-168
- Publication Year :
- 2016
- Publisher :
- American Society of Clinical Oncology (ASCO), 2016.
-
Abstract
- Purpose Breast implant–associated anaplastic large-cell lymphoma (BI-ALCL) is a rare type of T-cell lymphoma that arises around breast implants. The optimal management of this disease has not been established. The goal of this study is to evaluate the efficacy of different therapies used in patients with BI-ALCL to determine an optimal treatment approach. Patients and Methods In this study, we applied strict criteria to pathologic findings, assessed therapies used, and conducted a clinical follow-up of 87 patients with BI-ALCL, including 50 previously reported in the literature and 37 unreported. A Prentice, Williams, and Peterson model was used to assess the rate of events for each therapeutic intervention. Results The median and mean follow-up times were 45 and 30 months, respectively (range, 3 to 217 months). The median overall survival (OS) time after diagnosis of BI-ALCL was 13 years, and the OS rate was 93% and 89% at 3 and 5 years, respectively. Patients with lymphoma confined by the fibrous capsule surrounding the implant had better event-free survival (EFS) and OS than did patients with lymphoma that had spread beyond the capsule (P = .03). Patients who underwent a complete surgical excision that consisted of total capsulectomy with breast implant removal had better OS (P = .022) and EFS (P = .014) than did patients who received partial capsulectomy, systemic chemotherapy, or radiation therapy. Conclusion Surgical management with complete surgical excision is essential to achieve optimal EFS in patients with BI-ALCL.
- Subjects :
- Cancer Research
medicine.medical_treatment
Disease
030230 surgery
chemotherapy
law.invention
0302 clinical medicine
law
middle aged
80 and over
breast neoplasms
Medicine
humans
Anaplastic large-cell lymphoma
Aged, 80 and over
adult
ORIGINAL REPORTS
kaplan-meier estimate
follow-up studies
aged
aged, 80 and over
breast implants
chemotherapy, adjuvant
disease management
disease-free survival
female
lymphoma, large-cell, anaplastic
radiotherapy, adjuvant
retrospective studies
treatment outcome
cancer research
oncology
large-cell
Oncology
Chemotherapy, Adjuvant
030220 oncology & carcinogenesis
Breast implant
Lymphoma, Large-Cell, Anaplastic
Erratum
medicine.medical_specialty
lymphoma
anaplastic
03 medical and health sciences
adjuvant
radiotherapy
Chemotherapy
business.industry
Large cell
Retrospective cohort study
medicine.disease
Lymphoma
Surgery
Radiation therapy
Radiotherapy, Adjuvant
business
Subjects
Details
- ISSN :
- 15277755 and 0732183X
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....67cbbb7226aa12eb0d0600d4781b3982