BIA-ALCL and BIA-SCC: Updates on Clinical Features and Genetic Mutations for Latest Recommendations
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Epidemiology
3.2. Pathogenesis and Genetic Features
3.3. Clinical Aspects
3.4. Disease Diagnosis and Management
BIA-ALCL | BIA-SCC | |
---|---|---|
Tumor characterization | Non-Hodgkin T-cell anaplastic large lymphoma arising from the breast implant capsule | Squamous cell carcinoma (SCC) arising from the breast implant capsule. It should be distinguished from primary breast SCC. |
Known cases [5,6] | 1264 | 19 |
Mean age at diagnosis (Median) [5,6] | 54 | 53.5 |
Diagnosis following implantation (years range) [5,6] | 0–40 | 7–42 |
Implant type [5,6] | Silicone and Saline implants | Silicone and Saline implants |
Association with breast reconstruction [5,6] | Yes | Yes |
Association with breast augmentation [5,6] | Yes | Yes |
Implant texture [5,6] | Most cases have been associated with textured implants (73%). To date, an association with smooth implants cannot be excluded. | Textured implants Smooth implants |
Clinical presentations [10,11,12,13,14,15,16,17,52,53,57] | Late seroma Breast swelling Pain Erythema Capsular contracture Lymphadenopathy Mass/lump | Late seroma Breast swelling Pain Erythema Capsular contracture Lymphadenopathy Mass/lump |
Genetic susceptibility [29,36,37] | BIA-ALCL cases have been reported in patients with TP53 and BRCA1/2 mutations. Further investigation is required to define the associated risk. | Unknown |
Tumour genetics [40,41,42,50] | Several mutations have been identified (JAK1, STAT3, SOCS1, TP53, DNMT3A, K-RAS) | Unknown |
Diagnostic assessment [52] | If seroma is detected via US, US-guided FNA is recommended. Other imaging studies are performed based on clinical presentation (MRI); a biopsy is recommended in the presence of a mass. PET/CT is recommended for staging. | If seroma is detected via US, US-guided FNA is recommended. Other imaging studies are performed based on clinical presentation (MRI); a biopsy is recommended in the presence of a mass. PET/CT is recommended for staging. |
Tumour cell characterization [54] | Flow cytometry + for T-cells; CD30+; ALK−. | Flow cytometry + for squamous cells and keratin; CK 5/6+; p63+. |
Treatment [10,11,15,52,57,58] | For localized disease (Stages I-IIA), implant removal with en-bloc capsulectomy is recommended. For extracapsular disease (IIB-IV), implant removal with en-bloc capsulectomy is recommended. A multidisciplinary evaluation is required to evaluate adjuvant/neoadjuvant chemotherapy/immunotherapy and adjuvant radiotherapy. | Treatment recommendations are limited. En-bloc capsulectomy with implant removal is ordinarily performed. Adjuvant chemotherapy and radiotherapy have been utilized. |
Reported mortality [54] | 2.8% at one year | 43.8% at 6 months |
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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D’Orsi, G.; Giacalone, M.; Calicchia, A.; Gagliano, E.; Vannucchi, L.; Vanni, G.; Buonomo, O.C.; Cervelli, V.; Longo, B. BIA-ALCL and BIA-SCC: Updates on Clinical Features and Genetic Mutations for Latest Recommendations. Medicina 2024, 60, 793. https://doi.org/10.3390/medicina60050793
D’Orsi G, Giacalone M, Calicchia A, Gagliano E, Vannucchi L, Vanni G, Buonomo OC, Cervelli V, Longo B. BIA-ALCL and BIA-SCC: Updates on Clinical Features and Genetic Mutations for Latest Recommendations. Medicina. 2024; 60(5):793. https://doi.org/10.3390/medicina60050793
Chicago/Turabian StyleD’Orsi, Gennaro, Martina Giacalone, Alessio Calicchia, Elettra Gagliano, Lisa Vannucchi, Gianluca Vanni, Oreste Claudio Buonomo, Valerio Cervelli, and Benedetto Longo. 2024. "BIA-ALCL and BIA-SCC: Updates on Clinical Features and Genetic Mutations for Latest Recommendations" Medicina 60, no. 5: 793. https://doi.org/10.3390/medicina60050793
APA StyleD’Orsi, G., Giacalone, M., Calicchia, A., Gagliano, E., Vannucchi, L., Vanni, G., Buonomo, O. C., Cervelli, V., & Longo, B. (2024). BIA-ALCL and BIA-SCC: Updates on Clinical Features and Genetic Mutations for Latest Recommendations. Medicina, 60(5), 793. https://doi.org/10.3390/medicina60050793