Robert Jonathan Musmann, Peter G Cordeiro, Marc Daniels, Sonia Fertsch, Mazen Hagouan, Dennis C Hammond, Yves Harder, Jaume Masia, Charles Randquist, Roy De Vita, Andreas Wolter, Christoph Andree
This study reflects a conservative approach to managing breast implant-associated anaplastic large cell lymphoma among practitioners. The findings underscore the need for standardized implant registries and global reporting protocols to improve risk assessment and patient safety. Further research is essential to clarify the multifactorial etiology of breast implant-associated anaplastic large cell lymphoma and determine the efficacy of prophylactic explantation. Until more definitive evidence is available, individualized patient care with informed discussions and shared decision-making remains paramount.
BACKGROUND: Breast implant-associated anaplastic large cell lymphoma is a rare but significant complication of breast implants, with persistent uncertainties regarding its etiology, incidence, and optimal management strategies, particularly regarding prophylactic explantation in asymptomatic patients with textured implants. This study aims to assess current opinions and practices related to breast implant-associated anaplastic large cell lymphoma among experts in the field.
METHODS: A survey was submitted to faculty members (n = 37) and attendees (n = 75) of the 12th International Breast Symposium Düsseldorf in April 2024. The questionnaire captured personal experiences, diagnostic practices, and opinions on the prevention and management of breast implant-associated anaplastic large cell lymphoma.
RESULTS: Results indicated that 89% of both faculty members and attendees do not recommend prophylactic explantation of macrotextured implants in asymptomatic patients, aligning with current guidelines. While 62% of faculty members and 68% of attendees believe that the actual incidence of breast implant-associated anaplastic large cell lymphoma is higher than reported due to either underdiagnosis or under-reporting, 97% of faculty members and 96% of attendees routinely inform patients about the risks prior to surgery. Notably, 35% of faculty members and 73% of attendees had not encountered any cases of breast implant-associated anaplastic large cell lymphoma, despite heightened awareness.
CONCLUSIONS: This study reflects a conservative approach to managing breast implant-associated anaplastic large cell lymphoma among practitioners. The findings underscore the need for standardized implant registries and global reporting protocols to improve risk assessment and patient safety. Further research is essential to clarify the multifactorial etiology of breast implant-associated anaplastic large cell lymphoma and determine the efficacy of prophylactic explantation. Until more definitive evidence is available, individualized patient care with informed discussions and shared decision-making remains paramount.