Abstract: Epidemiology and Risk Factors for Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) in Australia & New Zealand (Plastic Surgery The Meeting)

Sunday, September 25, 2016: 1:45 PM

Robert John Knight, MB BCH (Rand), MRCS (Edin), MD, FRACS(Plast) , Plastic, Reconstructive and Aesthetic Surgery, Macquarie University, Sydney, Australia

Anna-Marie Veronika Loch-Wilkinson, MB.BS, B.App.Sc (Physio) , Plastic, Recosntructive and Aesthetic Surgery, Macquarie University, Sydney, Australia

William Louise Wessels, MB CHB, MMed, FCS(SA), FRACS(Plast) , Plastic, Recosntructive and Aesthetic Surgery, Macquarie University, Sydney, Australia

Timothy Papadopoulos, BSc, MBBS, FRACS (General) FRACS (Plastics) , Plastic, Recosntructive and Aesthetic Surgery, Macquarie University, Sydney, Australia

Mark Magnusson, MBBS, FRACS(Plast) , Plastic, Recosntructive and Aesthetic Surgery, Australasian Society of Aesthetic Plastic Surgeons, Sydney, Australia

Julian Lofts, MBBS, FRACS(Plast) , Plastic, Recosntructive and Aesthetic Surgery, Australasian Society of Aesthetic Plastic Surgeons, Sydney, Australia

Tony Connell, MBBS, FRACS(Plast) , Plastic Surgery, Mount Hospital, Subiaco, Australia

Kenneth John Beath, BE, MAppStat , Plastic, Recosntructive and Aesthetic Surgery, Macquarie University, Sydney, Australia

Ingrid Hooper, MBBS, BMedSci, FRACP , Epidemiology and preventative medicine, Monash Univeristy, Melbourne, Australia

Stephen Lade, MBBS, FRACPath , Department of Pathology, University of Melbourne, Melbourne, Australia

Henry Miles Prince, MBBS (Hons) MD FRACP FRCPA MACD AFRACMA , Department of Pathology, University of Melbourne, Melbourne, Australia

Anand K Deva, BSc(Med), MBBS, MS, FRACS , Surgical Infection Research Group, Macquarie University, Sydney, Australia

Presentation PDF file

Abstract

Breast implant associated large cell lymphoma (BIA-ALCL) is emerging as a herald diagnosis of increasing frequency. The underlying aetiology and pathogenesis remain unknown and are likely to involve a combination of implant type, chronic bacterial infection and host genetic susceptibility. We have noted a relatively high incidence of BIA-ALCL in the Australian/New Zealand (ANZ) population with over 30 reported cases for a combined population of only 26 million. This represents over 15 % of known cases around the world.

Methods

The index case in ANZ was diagnosed in January 2009. Since then 32 cases have been diagnosed. The ANZ cohort is being characterised and pathology from each case (where available) is being banked and re-examined. Sales data obtained from 2 leading implant manufacturers back to 2000 will enable calculation of incidence and implant specific risk.

Results (Preliminary)

The mean age of patients in this cohort is 52.7 (range 29-77). The mean duration between implant insertion and diagnosis was 8.8 years (range 3-25). 50% of the patients had implants for aesthetic surgery whilst the remaining half had implants for post-mastectomy reconstruction. The majority (63%) of patients presented with unilateral effusion. 21% presented with a tumour mass and the remaining had a combination of mass with effusion. All patients were exposed to textured implants for the majority of their implanted duration.

Epidemiology and risk calculation are still pending

Conclusions

We hope to present the first epidemiology and risk analysis based on real sales data of implants. It is hoped that these data will shed further light on the pathogenesis of BIA-ALCL and allow surgeons to more accurately inform patients of the likely incidence of BIA-ALCL when using breast implants.

30159 Epidemiology and Risk Factors for Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) in Australia & New Zealand