How common is lymphoma associated with implants?

Let’s go back to talking about the anaplastic large cell lymphoma associated with breast implants. Jama Oncology in fact, it has recently published a letter which estimates its impact in the United States. The new data comes from a study conducted by researchers from Columbia University in New York and funded by the National Cancer Institute.

The anaplastic large cell lymphoma (ALCL) that develops in the breast is a rather rare disease, according to the letter: it represents about 3% of all breast lymphomas and has been identified as a possible – albeit rare, in fact – effect adverse to prostheses, in particular texturized ones, ie prostheses used both in aesthetic surgery and in reconstructive surgery after oncological mastectomy, which have a “rough” surface.

Research

For the analysis, the researchers used data from the 18 Surveillance, Epidemiology, and End Results (SEER) registers collected between 2000 and 2018: the calculated (age-adjusted) incidence rate of lymphomas was of 8.1 cases per hundred million people each year, on average. The incidence appears to increase over the years: in fact, it has gone from 3.2 cases per hundred million cases registered between 2000 and 2005, to 4.4 between 2006 and 2011, to 14.5 between 2012 and 2018. The increase in incidence, they note, is in line with what has also been observed in the Netherlands, Australia and New Zealand. “Given the strong association with texturized implants, this increase could be related both to the increasing use of this type of prosthesis and to a greater sensitivity towards the disease, but it could also reflect an increase in the incidence of breast lymphomas.” “These are, of course, hypotheses that are not easily verifiable at the moment, but the objective data of an increase in this type of lymphoma remains”, he comments Andrea Sagonagynecologist and breast surgeon at the Breast Unit of the Humanitas Cancer Center in Rozzano.

The advice of the breast specialist

Currently, it is estimated that between 3% and 5% of adult women in the US have this type of prosthesis. For 2017, the authors calculated that there were between 310 and 350 cases of ALCL in the breast in the US. “These data should not alarm all patients who are carriers of texturized prostheses, but they are useful to stimulate an awareness, in this category of patients, of the possibility of developing this pathology. We remember, it can be suspected in case of sudden increase in breast volume, diffuse redness of the breast, presence of periprosthetic fluid or thickening of the capsule that covers the prosthesis. All signs evident in the exams and the clinical visit. It is therefore advisable to periodically undergo a breast examination and instrumental examinations, based on the age of the patient. Large cell lymphoma – concludes Sagona – usually has a good prognosis and often resolves with only the removal of the disease locally, whether or not associated with systemic chemotherapy treatments “.