Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL), first reported in 1997, is recognized in the 2016 edition of the World Health Organization as a subtype of the peripheral T-cell lymphomas.1 Whether they are filled with saline or silicone gel, the shells of breast implants can have smooth or textured surfaces. A textured-surface breast implant is associated with every case of BIA-ALCL where the entire breast implant history of the patient is known. Estimates of the lifetime risk of BIA-ALCL vary, ranging from 1 in 1000 to 1 in 30 000 patients with textured breast implants. As of May 2019, the American Society of Plastic Surgeons reports 722 distinct cases worldwide.2 On May 2, 2019, the US Food and Drug Administration (FDA),advocated for “strengthening the evidence generated to help inform future regulatory actions” but did not restrict access to any implants. By contrast, the National Agency for Medicine and Health Products of France banned textured breast implants from several manufacturers on April 2, 2019. Health Canada suspended the licenses of available macrotextured breast implants on May 28, 2019. Based on the available evidence, and the expectation that plastic surgeons will provide comprehensive information for patients to make an informed decision, we agree with the FDA’s measured approach.
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.
Myckatyn TM, Mehta-Shah N, Duncavage E. Breast Implant–Associated Anaplastic Large Cell Lymphoma: Real, Rare, but Avoidable. JAMA Surg. 2020;155(1):3–4. doi:10.1001/jamasurg.2019.3154
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: