Breast implant-associated anaplastic large cell lymphoma: where hematology and plastic surgery meet

Breast implant insertion for breast reconstruction or breast augmentation is a developing procedure, with high demand worldwide – being the 2nd most common plastic surgery in the US as of 2022. Breast – implant-associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is T-cell, non-Hodgkin lymphoma, typically CD30+, ALK-, presenting with fluid collection in the inner aspect of the peri-implant capsule in most patients, with the onset exceeding one-year after implantation. The mean time between breast implant insertion and BIA - ALCL development is 7-10 years. The main risk factor is the use of textured implants because of their susceptibility to triggering local inflammation and immune stimulation finally leading to lymphoproliferation. Genetic predispositions to hereditary breast cancer increase the risk of disease development as well. BIA-ALCL seems to be underestimated in many countries and the initial symptom–seroma might be overlooked and misdiagnosed. Despite its rarity, the awareness of the disease should be improved among patients and medical professionals. This paper summarizes epidemiology, etiopathogenesis, differential diagnosis, and treatment - both surgical and hematological approaches.