Laurie Margolies, MD; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Definitions
Cosmetic breast implant: Implant placed for augmentation or asymmetry
Implant reconstruction: Implant placed after mastectomy, usually for cancer
Contracture: Tightening of fibrous capsule around implant
Baker grade I (soft, normal appearance) to grade IV (hard, painful, abnormal-looking breast; rounded implant)
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Campanale A et al: 22 Cases of breast implant-associated ALCL: awareness and outcome tracking from the Italian Ministry of Health. Plast Reconstr Surg. 141(1):11e-19e, 2018
de Boer M et al: Breast implants and the risk of anaplastic large-cell lymphoma in the breast. JAMA Oncol. 4(3):335-341, 2018
Expert Panel on Breast Imaging et al: ACR Appropriateness Criteria® breast implant evaluation. J Am Coll Radiol. 15(5S):S13-S25, 2018
Fleming D et al: Spontaneous regression and resolution of breast implant-associated anaplastic large cell lymphoma: implications for research, diagnosis and clinical management. Aesthetic Plast Surg. 42(3):672-678, 2018
Mehta-Shah N et al: How I treat breast implant-associated anaplastic large cell lymphoma. Blood. 132(18):1889-98, 2018
Noroozian M et al: Use of screening mammography to detect occult malignancy in autologous breast reconstructions: a 15-year experience. Radiology. 172783, 2018
Sosin M et al: Breast cancer following augmentation mammaplasty: a case-control study. Plast Reconstr Surg. 141(4):833-40, 2018
Clemens MW et al: NCCN consensus guidelines for the diagnosis and management of breast implant-associated anaplastic large cell lymphoma. Aesthet Surg J. 37(3):285-9, 2017
Johnson L et al: Breast implant associated anaplastic large cell lymphoma: the UK experience. Recommendations on its management and implications for informed consent. Eur J Surg Oncol. 43(8):1393-1401, 2017
Leberfinger AN et al: Breast implant-associated anaplastic large cell lymphoma: a systematic review. JAMA Surg. 152(12):1161-8, 2017
Mango VL et al: Breast carcinoma in augmented breasts: MRI findings. AJR Am J Roentgenol. 204(5):W599-604, 2015
Noels EC et al: Breast implants and the risk of breast cancer: a meta-analysis of cohort studies. Aesthet Surg J. 35(1):55-62, 2015
Albornoz CR et al: A paradigm shift in U.S. Breast reconstruction: increasing implant rates. Plast Reconstr Surg. 131(1):15-23, 2013
Lavigne E et al: Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies. BMJ. 346:f2399, 2013
U.S. Food and Drug Administration: FDA medical device safety communication: reports of anaplastic large cell lymphoma (ALCL) in women with breast implants. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm240000.htm. Accessed May 25, 2013
Aladily TN et al: Breast implant-associated anaplastic large cell lymphoma: a newly recognized entity that needs further refinement of its definition. Leuk Lymphoma. 53(4):749-50, 2012
Kronowitz SJ: Current status of implant-based breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg. 130(4):513e-523e, 2012
Lavigne E et al: Do breast implants adversely affect prognosis among those subsequently diagnosed with breast cancer? Findings from an extended follow-up of a Canadian cohort. Cancer Epidemiol Biomarkers Prev. 21(10):1868-76, 2012
Pan SY et al: Canadian breast implant cohort: extended follow-up of cancer incidence. Int J Cancer. 131(7):E1148-57, 2012
Lipworth L et al: Cancer among Scandinavian women with cosmetic breast implants: a pooled long-term follow-up study. Int J Cancer. 124(2):490-3, 2009
Handel N et al: Breast cancer diagnosis and prognosis in augmented women. Plast Reconstr Surg. 118(3):587-93; discussion 594-6, 2006
Brown SL et al: Breast implant adverse events during mammography: reports to the Food and Drug Administration. J Womens Health (Larchmt). 13(4):371-8; discussion 379-80, 2004
Miglioretti DL et al: Effect of breast augmentation on the accuracy of mammography and cancer characteristics. JAMA. 291(4):442-50, 2004
Hoshaw SJ et al: Breast implants and cancer: causation, delayed detection, and survival. Plast Reconstr Surg. 107(6):1393-407, 2001
Handel N et al: Factors affecting mammographic visualization of the breast after augmentation mammaplasty. JAMA. 268(14):1913-7, 1992
Breast Implant-Associated Anaplastic Large Cell Lymphoma
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Imaging
Pathology
Clinical Issues
TERMINOLOGY
Definitions
Cosmetic breast implant: Implant placed for augmentation or asymmetry
Implant reconstruction: Implant placed after mastectomy, usually for cancer
Contracture: Tightening of fibrous capsule around implant
Baker grade I (soft, normal appearance) to grade IV (hard, painful, abnormal-looking breast; rounded implant)
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Campanale A et al: 22 Cases of breast implant-associated ALCL: awareness and outcome tracking from the Italian Ministry of Health. Plast Reconstr Surg. 141(1):11e-19e, 2018
de Boer M et al: Breast implants and the risk of anaplastic large-cell lymphoma in the breast. JAMA Oncol. 4(3):335-341, 2018
Expert Panel on Breast Imaging et al: ACR Appropriateness Criteria® breast implant evaluation. J Am Coll Radiol. 15(5S):S13-S25, 2018
Fleming D et al: Spontaneous regression and resolution of breast implant-associated anaplastic large cell lymphoma: implications for research, diagnosis and clinical management. Aesthetic Plast Surg. 42(3):672-678, 2018
Mehta-Shah N et al: How I treat breast implant-associated anaplastic large cell lymphoma. Blood. 132(18):1889-98, 2018
Noroozian M et al: Use of screening mammography to detect occult malignancy in autologous breast reconstructions: a 15-year experience. Radiology. 172783, 2018
Sosin M et al: Breast cancer following augmentation mammaplasty: a case-control study. Plast Reconstr Surg. 141(4):833-40, 2018
Clemens MW et al: NCCN consensus guidelines for the diagnosis and management of breast implant-associated anaplastic large cell lymphoma. Aesthet Surg J. 37(3):285-9, 2017
Johnson L et al: Breast implant associated anaplastic large cell lymphoma: the UK experience. Recommendations on its management and implications for informed consent. Eur J Surg Oncol. 43(8):1393-1401, 2017
Leberfinger AN et al: Breast implant-associated anaplastic large cell lymphoma: a systematic review. JAMA Surg. 152(12):1161-8, 2017
Mango VL et al: Breast carcinoma in augmented breasts: MRI findings. AJR Am J Roentgenol. 204(5):W599-604, 2015
Noels EC et al: Breast implants and the risk of breast cancer: a meta-analysis of cohort studies. Aesthet Surg J. 35(1):55-62, 2015
Albornoz CR et al: A paradigm shift in U.S. Breast reconstruction: increasing implant rates. Plast Reconstr Surg. 131(1):15-23, 2013
Lavigne E et al: Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies. BMJ. 346:f2399, 2013
U.S. Food and Drug Administration: FDA medical device safety communication: reports of anaplastic large cell lymphoma (ALCL) in women with breast implants. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm240000.htm. Accessed May 25, 2013
Aladily TN et al: Breast implant-associated anaplastic large cell lymphoma: a newly recognized entity that needs further refinement of its definition. Leuk Lymphoma. 53(4):749-50, 2012
Kronowitz SJ: Current status of implant-based breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg. 130(4):513e-523e, 2012
Lavigne E et al: Do breast implants adversely affect prognosis among those subsequently diagnosed with breast cancer? Findings from an extended follow-up of a Canadian cohort. Cancer Epidemiol Biomarkers Prev. 21(10):1868-76, 2012
Pan SY et al: Canadian breast implant cohort: extended follow-up of cancer incidence. Int J Cancer. 131(7):E1148-57, 2012
Lipworth L et al: Cancer among Scandinavian women with cosmetic breast implants: a pooled long-term follow-up study. Int J Cancer. 124(2):490-3, 2009
Handel N et al: Breast cancer diagnosis and prognosis in augmented women. Plast Reconstr Surg. 118(3):587-93; discussion 594-6, 2006
Brown SL et al: Breast implant adverse events during mammography: reports to the Food and Drug Administration. J Womens Health (Larchmt). 13(4):371-8; discussion 379-80, 2004
Miglioretti DL et al: Effect of breast augmentation on the accuracy of mammography and cancer characteristics. JAMA. 291(4):442-50, 2004
Hoshaw SJ et al: Breast implants and cancer: causation, delayed detection, and survival. Plast Reconstr Surg. 107(6):1393-407, 2001
Handel N et al: Factors affecting mammographic visualization of the breast after augmentation mammaplasty. JAMA. 268(14):1913-7, 1992
Breast Implant-Associated Anaplastic Large Cell Lymphoma
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