[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.226.208.185. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 172
Citations 0
Comment & Response
August 2018

Additional Risk Factors for Breast Implant–Associated Anaplastic Large Cell Lymphoma—Reply

Author Affiliations
  • 1Division of Plastic Surgery, Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
JAMA Surg. 2018;153(8):781-782. doi:10.1001/jamasurg.2018.1122

In Reply We thank Altundag and Fleury for their interest in our article.1 The pathogenesis of this rare disease entity is still under investigation. However, all cases with detailed implant history have been linked to textured implants.

Altundag commented on the lack of detailed information about the clinicopathological characteristics of the patients’ breast cancers as well as the chemotherapy and radiation therapy they received. This was a systematic review of the literature, and therefore, we were limited to previously published data. The vast majority of articles did not list any information about the clinicopathological details of the primary breast cancer and treatment. If information was reported, it was very basic (ie, stated that the patient underwent chemotherapy). We agree with Altundag that some breast cancer subtypes, such as triple-negative or human epidermal growth factor receptor 2–positive breast cancer, are more immunogenic. However, to our knowledge, there are no widespread data to suggest that these patients are more likely to develop breast implant–associated anaplastic large cell lymphoma (BIA-ALCL). Additionally, a significant number of patients with BIA-ALCL had cosmetic surgery without any history of breast cancer. This accounted for 46% of patients in our review article.1

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words
    ×