Breast Implant-associated Anaplastic Large Cell Lymphoma: A Canadian Surgical Oncology Survey

Lymphoma
02/11/2020

Plast Reconstr Surg Glob Open. 2020 Sep 24;8(9):e3091. doi: 10.1097/GOX.0000000000003091. eCollection 2020 Sep.

ABSTRACT

BACKGROUND: Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) awareness has increased, resulting in concerns regarding the safety of implant-based reconstruction. Breast cancer patients are first seen by surgical oncologists, who are therefore potentially the first health-care professionals to encounter concerns regarding BIA-ALCL. We therefore surveyed surgical oncologists on their understanding of BIA-ALCL to better assess potential effects on plastic surgery practice.

METHODS: An anonymous web-based survey consisting of 9 multiple-choice questions was sent to breast surgical oncologists that are members of the Canadian Society of Surgical Oncology (n = 135).

RESULTS: Forty-two members responded (n = 42/135, 31%) and all participants were aware of BIA-ALCL. All participants reported that BIA-ALCL has not deterred them from referring patients for implant-based reconstruction. Twenty-two respondents (52%) discuss BIA-ALCL with their patients and 21% (n = 9) believe that BIA-ALCL typically follows a metastatic course. Eight respondents (19%) reported having a poor understanding of BIA-ALCL, while 14% (n = 6) were unable to identify the link to textured implants. There were no statistical differences based on case-load volume.

CONCLUSIONS: Approximately half of the respondent Canadian breast surgical oncologists discuss BIA-ALCL with their patients, yet there is a knowledge gap in terms of the epidemiology and clinical-pathological course of BIA-ALCL. It is of utmost importance to ensure that the plastic surgery community aims at including surgical oncologist colleagues in educational platforms regarding BIA-ALCL to ensure collaboration and unity in an effort to offer the most accurate information to patients, and


prevent misinformation that may deter patients from seeking implant-based reconstruction.