Cargando…
Implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis
INTRODUCTION: Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare form of non-Hodgkin T-cell lymphoma associated with breast reconstruction post-mastectomy or cosmetic-additive mammoplasty. The increasing use of implants for cosmetic purposes is expected to lead to an incre...
Autores principales: | , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622658/ https://www.ncbi.nlm.nih.gov/pubmed/37927474 http://dx.doi.org/10.3389/fonc.2023.1202733 |
_version_ | 1785130588826501120 |
---|---|
author | Vittorietti, Martina Mazzola, Sergio Costantino, Claudio De Bella, Daniele Domenico Fruscione, Santo Bonaccorso, Nicole Sciortino, Martina Costanza, Davide Belluzzo, Miriam Savatteri, Alessandra Tramuto, Fabio Contiero, Paolo Tagliabue, Giovanna Immordino, Palmira Vitale, Francesco Di Napoli, Arianna Mazzucco, Walter |
author_facet | Vittorietti, Martina Mazzola, Sergio Costantino, Claudio De Bella, Daniele Domenico Fruscione, Santo Bonaccorso, Nicole Sciortino, Martina Costanza, Davide Belluzzo, Miriam Savatteri, Alessandra Tramuto, Fabio Contiero, Paolo Tagliabue, Giovanna Immordino, Palmira Vitale, Francesco Di Napoli, Arianna Mazzucco, Walter |
author_sort | Vittorietti, Martina |
collection | PubMed |
description | INTRODUCTION: Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare form of non-Hodgkin T-cell lymphoma associated with breast reconstruction post-mastectomy or cosmetic-additive mammoplasty. The increasing use of implants for cosmetic purposes is expected to lead to an increase in BIA-ALCL cases. This study investigated the main characteristics of the disease and the factors predicting BIA-ALCL onset in patients with and without an implant replacement. METHODS: A quantitative analysis was performed by two independent researchers on cases extracted from 52 primary studies (case report, case series, and systematic review) published until April 2022 and searched in PubMed, Scopus, and Google-Scholar databases using “Breast-Implant” AND/OR “Associated” AND/OR “Anaplastic-Large-Cell-Lymphoma”. The statistical significance was verified by Student’s t-test for continuous variables, while Fisher’s exact test was applied for qualitative variables. Cox model with time-dependent covariates was used to estimate BIA-ALCL’s onset time. The Kaplan–Meier model allowed the estimation of the probability of survival after therapy according to breast implant exposure time. RESULTS: Overall, 232 patients with BIA-ALCL were extracted. The mean age at diagnosis was 55 years old, with a mean time to disease onset from the first implant of 10.3 years. The hazard of developing BIA-ALCL in a shorter time resulted significantly higher for patients not having an implant replacement (hazard ratio = 0.03; 95%CI: 0.005–0.19; p-value < 0.01). Patients with implant replacement were significantly older than patients without previous replacement at diagnosis, having a median time to diagnosis since the first implant of 13 years (7 years in patients without replacement); anyway, the median time to BIA-ALCL occurrence since the last implantation was equal to 5 years. DISCUSSION: Our findings suggest that, in BIA-ALCL patients, the implant substitution and/or capsulectomy may delay the disease’s onset. However, the risk of reoccurrence in an earlier time should be considered in these patients. Moreover, the time to BIA-ALCL onset slightly increased with age. Selection bias, lack of awareness, misdiagnosis, and limited data availability could be identified as limits of our study. An implant replacement should be considered according to a risk stratification approach to delay the BIA-ALCL occurrence in asymptomatic patients, although a stricter follow-up after the implant substitution should be recommended. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42023446726. |
format | Online Article Text |
id | pubmed-10622658 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-106226582023-11-04 Implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis Vittorietti, Martina Mazzola, Sergio Costantino, Claudio De Bella, Daniele Domenico Fruscione, Santo Bonaccorso, Nicole Sciortino, Martina Costanza, Davide Belluzzo, Miriam Savatteri, Alessandra Tramuto, Fabio Contiero, Paolo Tagliabue, Giovanna Immordino, Palmira Vitale, Francesco Di Napoli, Arianna Mazzucco, Walter Front Oncol Oncology INTRODUCTION: Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare form of non-Hodgkin T-cell lymphoma associated with breast reconstruction post-mastectomy or cosmetic-additive mammoplasty. The increasing use of implants for cosmetic purposes is expected to lead to an increase in BIA-ALCL cases. This study investigated the main characteristics of the disease and the factors predicting BIA-ALCL onset in patients with and without an implant replacement. METHODS: A quantitative analysis was performed by two independent researchers on cases extracted from 52 primary studies (case report, case series, and systematic review) published until April 2022 and searched in PubMed, Scopus, and Google-Scholar databases using “Breast-Implant” AND/OR “Associated” AND/OR “Anaplastic-Large-Cell-Lymphoma”. The statistical significance was verified by Student’s t-test for continuous variables, while Fisher’s exact test was applied for qualitative variables. Cox model with time-dependent covariates was used to estimate BIA-ALCL’s onset time. The Kaplan–Meier model allowed the estimation of the probability of survival after therapy according to breast implant exposure time. RESULTS: Overall, 232 patients with BIA-ALCL were extracted. The mean age at diagnosis was 55 years old, with a mean time to disease onset from the first implant of 10.3 years. The hazard of developing BIA-ALCL in a shorter time resulted significantly higher for patients not having an implant replacement (hazard ratio = 0.03; 95%CI: 0.005–0.19; p-value < 0.01). Patients with implant replacement were significantly older than patients without previous replacement at diagnosis, having a median time to diagnosis since the first implant of 13 years (7 years in patients without replacement); anyway, the median time to BIA-ALCL occurrence since the last implantation was equal to 5 years. DISCUSSION: Our findings suggest that, in BIA-ALCL patients, the implant substitution and/or capsulectomy may delay the disease’s onset. However, the risk of reoccurrence in an earlier time should be considered in these patients. Moreover, the time to BIA-ALCL onset slightly increased with age. Selection bias, lack of awareness, misdiagnosis, and limited data availability could be identified as limits of our study. An implant replacement should be considered according to a risk stratification approach to delay the BIA-ALCL occurrence in asymptomatic patients, although a stricter follow-up after the implant substitution should be recommended. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42023446726. Frontiers Media S.A. 2023-10-19 /pmc/articles/PMC10622658/ /pubmed/37927474 http://dx.doi.org/10.3389/fonc.2023.1202733 Text en Copyright © 2023 Vittorietti, Mazzola, Costantino, De Bella, Fruscione, Bonaccorso, Sciortino, Costanza, Belluzzo, Savatteri, Tramuto, Contiero, Tagliabue, Immordino, Vitale, Di Napoli and Mazzucco https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Vittorietti, Martina Mazzola, Sergio Costantino, Claudio De Bella, Daniele Domenico Fruscione, Santo Bonaccorso, Nicole Sciortino, Martina Costanza, Davide Belluzzo, Miriam Savatteri, Alessandra Tramuto, Fabio Contiero, Paolo Tagliabue, Giovanna Immordino, Palmira Vitale, Francesco Di Napoli, Arianna Mazzucco, Walter Implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis |
title | Implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis |
title_full | Implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis |
title_fullStr | Implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis |
title_full_unstemmed | Implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis |
title_short | Implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis |
title_sort | implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10622658/ https://www.ncbi.nlm.nih.gov/pubmed/37927474 http://dx.doi.org/10.3389/fonc.2023.1202733 |
work_keys_str_mv | AT vittoriettimartina implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT mazzolasergio implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT costantinoclaudio implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT debelladanieledomenico implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT fruscionesanto implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT bonaccorsonicole implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT sciortinomartina implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT costanzadavide implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT belluzzomiriam implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT savatterialessandra implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT tramutofabio implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT contieropaolo implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT tagliabuegiovanna implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT immordinopalmira implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT vitalefrancesco implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT dinapoliarianna implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis AT mazzuccowalter implantreplacementandanaplasticlargecelllymphomaassociatedwithbreastimplantsaquantitativeanalysis |