To the Editor I want to congratulate Leberfinger et al1 for their systematic review including 95 patients with breast implant–associated anaplastic large cell lymphoma. The underlying mechanism is briefly described as chronic inflammation from indolent infections, leading to malignant transformation of T cells that are anaplastic lymphoma kinase negative and CD30 positive. However, the authors did not give detailed information about the clinicopathological characteristics of the chemotherapy schedules and radiotherapy that patients with breast cancer received, which might be risk factors for the development of breast implant–associated anaplastic large cell lymphoma. Some breast cancer subtypes, such as triple-negative or human epidermal growth factor receptor 2–positive breast cancer, are more immunogenic and tend to develop more breast implant–associated anaplastic large cell lymphoma.2
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Altundag K. Additional Risk Factors for Breast Implant–Associated Anaplastic Large Cell Lymphoma. JAMA Surg. 2018;153(8):780. doi:10.1001/jamasurg.2018.1116
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