BIA-ALCL study shows multi-team treatment key to achieving best outcomes

A team of researchers from across five disciplines at MD Anderson recently published the largest prospective study on breast implant associated anaplastic large cell lymphoma (BIA-ALCL), shedding light on the best treatment for patients with this uncommon cancer.

“This study underscores the critical importance of a standard treatment approach with a multi-team evaluation,” saysMark Clemens, M.D., the senior author of the study, which发表在外科年鉴.

Researchers in breast surgery, hematopathology, radiation oncology, lymphoma oncology and plastic surgery came together to develop an algorithmic approach to treat the study participants, all of whom reached complete remission.

A clear path for BIA-ALCL treatment

BIA-ALCL的固体肿瘤分期首先由MD安德森的作者在2016年描述虽然在BIA-ALCL以往的研究对全球患者资料或情况报告的审查依赖，这五年的研究纳入52例患者，在所有MD安德森，在疾病的不同阶段。这些患者中，25％在疾病的早期阶段，称为第一阶段IA进行了治疗，但一些有IV期，有转移到骨髓，肝脏，肠子和。

“What we found is that most patients can be treated with surgery alone, and importantly in advanced disease, we clarified who best responds to the addition ofchemotherapy, targetedimmunotherapy,辐射andstem cell transplants,” Clemens says.

This study also demonstrated that with early diagnosis, better outcomes could be achieved. While all patients in this study reached remission, the Food and Drug Administration (FDA) has previously reported that 33 deaths have occurred worldwide overlapping the time the study was conducted. This emphasizes that a good prognosis is dependent on appropriate diagnosis and a standardized multi-team treatment approach.

Shedding light on an uncommon cancer

Breast implant associated anaplastic large cell lymphoma is classified as an uncommon cancer by the FDA. It is believed to be associated with textured-surface breast implants, and the overall incidence is low. Between one in 355 to 50,000 of these individuals develop the disease depending on different types of textured implants, with the highest risk devices recalled by the FDA in 2019.

Consequently, little has been known about this cancer until recently. The FDA first reported a possible link between breast implants and anaplastic large cell lymphoma in 2011. For years, it was difficult to diagnosis and treat. Then, in February 2020,new diagnosis guidelines developed by the MD Anderson researchersin collaboration with the NIH and FDA were published in theJournal of Clinical Oncology, helping providers recognize, diagnose and stage BIA-ALCL.

This latest study builds on that work and underlines the need for increased awareness of this disease. Patients should talk to their doctors if they notice breast swelling, asymmetry or unexplained sensations of fullness – all BIA-ALCL symptoms. If the physician suspects BIA-ALCL, ultrasound-guided fine needle aspiration of the fluid collection around the implant is used the obtain a correct diagnosis.

“This study demonstrated the importance of pre-operative diagnostic testing and imaging,” Clemens says. “This optimizes treatment, patient outcomes and long-term surveillance.”

Refer a patient to MD Anderson onlineor by calling 1-877-632-6789.