Breast Implant–associated Anaplastic Large Cell Lymphoma: Updated Results from a Structured Expert Consultation Process
Background: Despite increased cases published on breast implant–associated anaplastic large cell lymphoma (BIA-ALCL), important clinical issues remain unanswered. We conducted a second structured expert consultation process to rate statements related to the diagnosis, management, and surveillance of...
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| Formato: | Artigo |
| Idioma: | English |
| Publicado em: |
Wolters Kluwer
2015-01-01
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| Colecção: | Plastic and Reconstructive Surgery, Global Open |
| Acesso em linha: | http://journals.lww.com/prsgo/Fulltext/2015/01000/Article.2.aspx |
| _version_ | 1828280610866593792 |
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| author | Benjamin Kim, MD, MPhil Zachary S. Predmore, BA Soeren Mattke, MD, DSc Kristin van Busum, MPA Courtney A. Gidengil, MD, MPH |
| author_facet | Benjamin Kim, MD, MPhil Zachary S. Predmore, BA Soeren Mattke, MD, DSc Kristin van Busum, MPA Courtney A. Gidengil, MD, MPH |
| author_sort | Benjamin Kim, MD, MPhil |
| collection | DOAJ |
| description | Background: Despite increased cases published on breast implant–associated anaplastic large cell lymphoma (BIA-ALCL), important clinical issues remain unanswered. We conducted a second structured expert consultation process to rate statements related to the diagnosis, management, and surveillance of this disease, based on their interpretation of published evidence.
Methods: A multidisciplinary panel of 12 experts was selected based on nominations from national specialty societies, academic department heads, and recognized researchers in the United States.
Results: Panelists agreed that (1) this disease should be called “BIA-ALCL”; (2) late seromas occurring >1 year after breast implantation should be evaluated via ultrasound, and if a seroma is present, the fluid should be aspirated and sent for culture, cytology, flow cytometry, and cell block to an experienced hematopathologist; (3) surgical removal of the affected implant and capsule (as completely as possible) should occur, which is sufficient to eradicate capsule-confined BIA-ALCL; (4) surveillance should consist of clinical follow-up at least every 6 months for at least 5 years and breast ultrasound yearly for at least 2 years; and (5) BIA-ALCL is generally a biologically indolent disease with a good prognosis, unless it extends beyond the capsule and/or presents as a mass. They firmly disagreed with statements that chemotherapy and radiation therapy should be given to all patients with BIA-ALCL.
Conclusions: Our assessment yielded consistent results on a number of key, incompletely addressed issues regarding BIA-ALCL, but additional research is needed to support these statement ratings and enhance our understanding of the biology, treatment, and outcomes associated with this disease. |
| first_indexed | 2024-04-13T08:02:08Z |
| format | Article |
| id | doaj.art-15d3e29e4c3c4c098e81d5e3d0aa8a08 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-13T08:02:08Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-15d3e29e4c3c4c098e81d5e3d0aa8a082022-12-22T02:55:15ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742015-01-0131e29610.1097/GOX.000000000000026801720096-201501000-00002Breast Implant–associated Anaplastic Large Cell Lymphoma: Updated Results from a Structured Expert Consultation ProcessBenjamin Kim, MD, MPhil0Zachary S. Predmore, BA1Soeren Mattke, MD, DSc2Kristin van Busum, MPA3Courtney A. Gidengil, MD, MPH4From the RAND Health, RAND Corporation, Boston, Mass.From the RAND Health, RAND Corporation, Boston, Mass.From the RAND Health, RAND Corporation, Boston, Mass.From the RAND Health, RAND Corporation, Boston, Mass.From the RAND Health, RAND Corporation, Boston, Mass.Background: Despite increased cases published on breast implant–associated anaplastic large cell lymphoma (BIA-ALCL), important clinical issues remain unanswered. We conducted a second structured expert consultation process to rate statements related to the diagnosis, management, and surveillance of this disease, based on their interpretation of published evidence. Methods: A multidisciplinary panel of 12 experts was selected based on nominations from national specialty societies, academic department heads, and recognized researchers in the United States. Results: Panelists agreed that (1) this disease should be called “BIA-ALCL”; (2) late seromas occurring >1 year after breast implantation should be evaluated via ultrasound, and if a seroma is present, the fluid should be aspirated and sent for culture, cytology, flow cytometry, and cell block to an experienced hematopathologist; (3) surgical removal of the affected implant and capsule (as completely as possible) should occur, which is sufficient to eradicate capsule-confined BIA-ALCL; (4) surveillance should consist of clinical follow-up at least every 6 months for at least 5 years and breast ultrasound yearly for at least 2 years; and (5) BIA-ALCL is generally a biologically indolent disease with a good prognosis, unless it extends beyond the capsule and/or presents as a mass. They firmly disagreed with statements that chemotherapy and radiation therapy should be given to all patients with BIA-ALCL. Conclusions: Our assessment yielded consistent results on a number of key, incompletely addressed issues regarding BIA-ALCL, but additional research is needed to support these statement ratings and enhance our understanding of the biology, treatment, and outcomes associated with this disease.http://journals.lww.com/prsgo/Fulltext/2015/01000/Article.2.aspx |
| spellingShingle | Benjamin Kim, MD, MPhil Zachary S. Predmore, BA Soeren Mattke, MD, DSc Kristin van Busum, MPA Courtney A. Gidengil, MD, MPH Breast Implant–associated Anaplastic Large Cell Lymphoma: Updated Results from a Structured Expert Consultation Process Plastic and Reconstructive Surgery, Global Open |
| title | Breast Implant–associated Anaplastic Large Cell Lymphoma: Updated Results from a Structured Expert Consultation Process |
| title_full | Breast Implant–associated Anaplastic Large Cell Lymphoma: Updated Results from a Structured Expert Consultation Process |
| title_fullStr | Breast Implant–associated Anaplastic Large Cell Lymphoma: Updated Results from a Structured Expert Consultation Process |
| title_full_unstemmed | Breast Implant–associated Anaplastic Large Cell Lymphoma: Updated Results from a Structured Expert Consultation Process |
| title_short | Breast Implant–associated Anaplastic Large Cell Lymphoma: Updated Results from a Structured Expert Consultation Process |
| title_sort | breast implant associated anaplastic large cell lymphoma updated results from a structured expert consultation process |
| url | http://journals.lww.com/prsgo/Fulltext/2015/01000/Article.2.aspx |
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