Riccardo Carbonaro, Giuseppe Accardo, Luca Mazzocconi, Stefano Pileri, Enrico Derenzini, Paolo Veronesi, Pietro Caldarella, Francesca De Lorenzi

BIA-ALCL in patients with genetic predisposition for breast cancer: our experience and a review of the literature

  • Cancer Research
  • Public Health, Environmental and Occupational Health
  • Oncology
  • Epidemiology
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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an emerging non-Hodgkin’s lymphoma that occurs exclusively in patients with breast implants. The estimated risk of developing BIA-ALCL from exposure to breast implants is largely based on approximations about patients at risk. There is a growing body of evidence regarding the presence of specific germline mutations in patients developing BIA-ALCL, rising interest regarding possible markers of genetic predisposition to this type of lymphoma. The present paper focuses attention on BIA-ALCL in women with a genetic predisposition for breast cancer. We report our experience at the European Institute of Oncology, Milan, Italy, describing a case of BIA-ALCL in aBRCA1mutation carrier who developed BIA-ALCL 5 years after implant-based post mastectomy reconstruction. She was treated successfully with an en-bloc capsulectomy. Additionally, we review the available literature on inherited genetic factors predisposing to the development of BIA-ALCL. In patients with genetic predisposition to breast cancer (mainlyTP53andBRCA1/2germline mutations), BIA-ALCL prevalence seems to be higher and time to onset appears to be shorter in comparison to the general population. These high-risk patients are already included in close follow-up programs allowing the diagnosis of early-stage BIA-ALCL. For this reason, we do not believe that a different approach should be followed for postoperative surveillance.

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