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BIA-ALCL — SCE Medical Oncology MCQ

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HardBreast CancerBIA-ALCLSCE Medical Oncology

A 65-year-old woman with breast implant-associated large cell lymphoma (BIA-ALCL) presents with a unilateral seroma around her textured breast implant 10 years after augmentation. Cytology confirms ALK-negative, CD30-positive T-cell lymphoma. What is the primary treatment?

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Correct answer: B — Complete surgical excision — bilateral capsulectomy with implant removal

BIA-ALCL is a rare T-cell lymphoma associated with textured breast implants (risk approximately 1 in 3,000-30,000 textured implants). It typically presents as a late periprosthetic seroma. Complete surgical excision (en-bloc capsulectomy with implant removal) is curative for disease confined to the capsule (stage I). Contralateral implant removal is also recommended. Systemic chemotherapy (CHOP ± brentuximab vedotin) is reserved for advanced/disseminated disease. MHRA issued a safety alert regarding textured implants.

Reference: NICE; MHRA BIA-ALCL Safety Alert; ESMO 2024; Clemens et al JAMA Surgery 2019