Breast lymphoma

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)

• Rare T cell NHL that develops in capsular tissue
• Usually in textured implants, rather than smooth
• 1:3,000 to 1:30,000
• Pathophysiology
  • Potentially related to chronic subacute infection/biofilm, and sustained T cell response
• Usually presents as a delayed-onset painless seroma 3-14 years after implantation
• Evaluate with MRI, cytology CD30+, capsular or LN biopsy
• Treatment:
  • Removal of implant and capsule
  • CTX if pathology has extended beyond capsule
    • Usually CHOP +/- CD30 monoclonal Ab e.g. brentuximab