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Study Finds Association Between Breast Implants and Risk of Anaplastic Large Cell Lymphoma

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Key Points

  • Breast implants were associated with a small increased risk of breast ALCL.
  • It was estimated that one case of breast ALCL would occur for every 6,920 women with implants before age 75 years.

In a Dutch study reported in JAMA Oncology, de Boer et al found that breast implants were associated with an increased risk of anaplastic large cell lymphoma (ALCL) in the breast, although the absolute risk was small.

Study Details

In the study, all patients diagnosed with primary non-Hodgkin lymphoma of the breast between 1990 and 2016 were identified through the nationwide Dutch pathology registry, and clinical data—including breast implant status—were obtained from treating physicians. Odds ratios (ORs) of ALCL associated with breast implants were derived using a case-control design comparing implant prevalence among women with breast ALCL vs women with other types of breast lymphoma. Cumulative risk of breast ALCL was derived from the age-specific prevalence of breast implants in women as estimated from examination of 3000 chest x-rays and time trends from implant sales.

Risk of Breast ALCL

Of a total of 43 women with breast ALCL (median age = 59 years), 32 had ipsilateral breast implants, compared with 1 of 146 women with other primary breast lymphomas (OR = 421.8, 95% confidence interval = 52.6–3385.2). Of 28 implants of known type in breast ALCL cases, 23 (82%) were macrotextured; by comparison, macrotextured implants accounted for 49,193 (45%) of a total of 109,449 implants sold between 2010 and 2015 (P < .001). Overall, the estimated prevalence of breast implants in women aged 20 to 70 years was 3.3%. The cumulative risks of breast ALCL in women with implants were 29 per million persons at age 50 years and 82 per million persons at age 70. It was estimated that one case of breast ALCL would occur for every 6,920 women with implants before age 75 years.

The investigators concluded, “Breast implants are associated with increased risk of breast-ALCL, but the absolute risk remains small. Our results emphasize the need for increased awareness among the public, medical professionals, and regulatory bodies; promotion of alternative cosmetic procedures; and alertness to signs and symptoms of breast ALCL in women with implants.”

Daphne de Jong, MD, PhD, of the Department of Pathology, VU University Medical Center, is the corresponding author for the JAMA Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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