To the Editor I read with great interest the systematic review by Leberfinger et al1 on breast implant–associated anaplastic large cell lymphoma (BIA-ALCL). The authors analyze 95 patients with BIA-ALCL and suppose it is caused by a complex process involving many factors, including bacterial biofilm growth, textured implant surface, immune response, and genetics of the patient. They also state that none of the reported patients presented with anaplastic lymphoma kinase,1 which is typically found in 60% of patients with systemic ALCL. Leberfinger et al1 raise the possibility that the BIA-ALCL is related to an inflammatory process secondary to a reaction process to the breast implant. They also speculate that the literature establishes that chronic inflammation can lead to a lymphoma.
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Fleury EDFC. Additional Risk Factors for Breast Implant–Associated Anaplastic Large Cell Lymphoma. JAMA Surg. 2018;153(8):780–781. doi:10.1001/jamasurg.2018.1119
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