Lymphoma associated with breast implants: two case-reports and a review of the literature (3 studies)

[Guest guest]

Dear Group,

We have a new member who has been diagnosed with lymphoma after McGhan saline implants.

Here are 3 studies I found in a quick review ... if you have any additional information I can forward on to her, please let me know. She has an upcoming appointment very soon.

Best from Ilena

Leuk Lymphoma. 2002 Jan;43(1):115-9.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=11908714 & dopt=Abstract

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Breast lymphoma associated with breast implants: two case-reports and a review of the literature.

Gaudet G,

Friedberg JW,

Weng A,

Pinkus GS,

Freedman AS.Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, MA 02115, USA.Breast lymphoma is a rare entity consisting mostly of B-cell lymphomas that affects older women. Very few cases of breast lymphomas of T-cell origin have been reported. Even fewer cases of breast lymphomas have been reported in women who have received breast implants. Silicone, a frequent component of breast implants, has been extensively investigated as a possible etiologic agent for some neoplasias and autoimmune disorders, including non-Hodgkin's lymphoma. We herein report two unusual cases of anaplastic large cell lymphoma of T-cell phenotype developing in the breasts of women who had received breast implants.

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http://arpa.allenpress.com/arpaonline/?request=get-document & doi=10.1043%2F0003-9985(2003)127%3Ce115:ALCLAI%3E2.0.CO%3B2

Archives of Pathology and Laboratory Medicine: Vol. 127, No. 3, pp. e115–e118.

Anaplastic Large Cell Lymphoma Arising in a Silicone Breast Implant Capsule: A Case Report and Review of the Literature

Sunati Sahoo, MD; P. Rosen, MD; M. Feddersen, MD; S. Viswanatha, MD; A. , MD; Amy Chadburn, MD

From the Department of Pathology, New York Presbyterian Hospital-Weill Cornell Center, New York, NY (Drs Sahoo, Rosen, and Chadburn); the Department of Pathology, University of New Mexico School of Medicine, Albuquerque (Drs Feddersen and Viswanatha); and New Mexico Oncology Hematology Consultants, Albuquerque (Dr )

Accepted June 14, 2002

Anaplastic large cell lymphoma is a rare type of primary breast lymphoma. We report a case of anaplastic large cell lymphoma, T-cell phenotype, occurring in the periprosthetic capsule of a silicone breast prosthesis 9 years after implantation for augmentation mammoplasty. This case is unique for its unusual presentation.

Since 1962, an estimated 1 to 2 million women have acquired breast implants in the United States.

1 Approximately 80% of these implants have been placed for breast augmentation, and almost all of the others have been used for reconstruction after mastectomy due to cancer.

1 The physical and psychological benefits of breast implants for mastectomy patients have been well documented. Despite early reports that silicone was biologically inert in human tissue, the safety of breast implants for augmentation mammoplasty has been a subject of much discussion with respect to local and potential systemic complications, including carcinogenic effects. An independent panel of US scientists convened at the request of Congress concluded that silicone breast implants do not cause any systemic disease, but these implants can leak and rupture, causing local problems such as scarring, infection, and disfigurement. There is no convincing evidence that these local effects predispose women to the development of lymphoma in the breast, although there have been rare reports of lymphoma in the vicinity of breast implants.

2–4 This report documents a case of primary anaplastic large cell lymphoma (ALCL) of the breast that arose in the periprosthetic tissue of a silicone implant.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=7751462 & dopt=Abstract

J Am Acad Dermatol. 1995 Jun;32(6):939-42.

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Comment in:

J Am Acad Dermatol. 1995 Dec;33(6):1060-1.Cutaneous T-cell lymphoma in association with silicone breast implants.

Duvic M,

D,

Menter A,

Vonderheid EC.Department of Dermatology, University of Texas Medical School Houston, USA. BACKGROUND: Cutaneous T-cell lymphoma (CTCL) is a chronic malignancy of helper T cells with the CD4 phenotype. It occurs less frequently in young women but is increasing in incidence for unknown reasons. Silicone breast implants have been associated with T-cell-mediated autoimmune reactions. OBJECTIVE: Our purpose was to suggest the hypothesis that CTCL may arise after breast implants and that different patients with CTCL may be stimulated by different antigens. METHODS: Investigators with many patients with CTCL were queried regarding the occurrence of CTCL in women after breast implants. RESULTS: Three cases of confirmed CTCL after breast implants were identified and are reported. In one patient with Sezary syndrome and CTCL, the disease went into remission after removal of implants, resolution of chronic staphylococcal infection, and initiation of photopheresis and interferon alfa therapy. Another patient had progressive disease. CONCLUSION: CTCL may occur in association with breast implants in young female patients, but causality is unknown. If CTCL is antigen driven, then it is likely to result from several different antigens in different groups of patients.