An advanced case of breast implant-associated anaplastic large cell lymphoma

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of non-Hodgkin lymphoma that was first described in the literature in 1997. The most common clinical presentation of BIA-ALCL is a persistent seroma, which can be accompanied by breast swelling, asymmetry, or pain. Approximately 30% of patients present with a tumor mass. Case Report: A 66-year-old woman underwent bilateral mastectomies and immediate implant reconstruction for screen detected ductal carcinoma in situ (DCIS) of the right breast in January 2016. Four years later the patient presented with a right breast mass that developed over a period of weeks. Radiological and pathological investigations confirmed the presence of multifocal mass forming BIA-ALCL with axillary, sub-pectoral, and intra-mammary lymph node involvement. Following multi-disciplinary team (MDT) input, definite was surgery and was also performed. En bloc resection of the right breast tumors and capsulectomy was performed in parallel with left breast explantation and capsulectomy. An axillary lymph node clearance of the right axilla was performed. The patient had an uneventful postoperative recovery and was discharged on post-operative day 5. Following MDT discussion the patient is awaiting adjuvant chemo/radiation therapy. Conclusion: All patients presenting with a delayed spontaneous seroma (>1 year after implantation) after placement of a textured implant should be investigated for BIA-ALCL. In the majority of cases explantation and total capsulectomy is curative and patients will have an excellent survival outcome.