Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand: High-Surface-Area Textured Implants Are Associated with Increased Risk
01 Oct 2017-Plastic and Reconstructive Surgery (LIPPINCOTT WILLIAMS & WILKINS)-Vol. 140, Iss: 4, pp 645-654
TL;DR: Higher-surface-area textured implants have been shown to significantly increase the risk of breast implant–associated ALCL in Australia and New Zealand and the authors present a unifying hypothesis to explain these observations.
Abstract: Background:The association between breast implants and breast implant–associated anaplastic large cell lymphoma (ALCL) has been confirmed. Implant-related risk has been difficult to estimate to date due to incomplete datasets.Methods:All cases in Australia and New Zealand were identified and analyze
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01 Jan 2016
TL;DR: This application applied longitudinal data analysis modeling change and event occurrence will help people to enjoy a good book with a cup of coffee in the afternoon instead of facing with some infectious virus inside their computer.
Abstract: Thank you very much for downloading applied longitudinal data analysis modeling change and event occurrence. As you may know, people have look hundreds times for their favorite novels like this applied longitudinal data analysis modeling change and event occurrence, but end up in malicious downloads. Rather than enjoying a good book with a cup of coffee in the afternoon, instead they are facing with some infectious virus inside their computer.
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TL;DR: The results emphasize the need for increased awareness among the public, medical professionals, and regulatory bodies, promotion of alternative cosmetic procedures, and alertness to signs and symptoms of breast-ALCL in women with implants.
Abstract: Importance Breast implants are among the most commonly used medical devices. Since 2008, the number of women with breast implants diagnosed with anaplastic large-cell lymphoma in the breast (breast-ALCL) has increased, and several reports have suggested an association between breast implants and risk of breast-ALCL. However, relative and absolute risks of breast-ALCL in women with implants are still unknown, precluding evidence-based counseling about implants. Objective To determine relative and absolute risks of breast-ALCL in women with breast implants. Design, Setting, and Participants Through the population-based nationwide Dutch pathology registry we identified all patients diagnosed with primary non-Hodgkin lymphoma in the breast between 1990 and 2016 and retrieved clinical data, including breast implant status, from the treating physicians. We estimated the odds ratio (OR) of ALCL associated with breast implants in a case-control design, comparing implant prevalence between women with breast-ALCL and women with other types of breast lymphoma. Cumulative risk of breast-ALCL was derived from the age-specific prevalence of breast implants in Dutch women, estimated from an examination of 3000 chest x-rays and time trends from implant sales. Main Outcomes and Measures Relative and absolute risks of breast-ALCL in women with breast implants. Results Among 43 patients with breast-ALCL (median age, 59 years), 32 had ipsilateral breast implants, compared with 1 among 146 women with other primary breast lymphomas (OR, 421.8; 95% CI, 52.6-3385.2). Implants among breast-ALCL cases were more often macrotextured (23 macrotextured of 28 total implants of known type, 82%) than expected (49 193 sold macrotextured implants of total sold 109 449 between 2010 and 2015, 45%) based on sales data (P Conclusions and Relevance Breast implants are associated with increased risk of breast-ALCL, but the absolute risk remains small. Our results emphasize the need for increased awareness among the public, medical professionals, and regulatory bodies, promotion of alternative cosmetic procedures, and alertness to signs and symptoms of breast-ALCL in women with implants.
229 citations
TL;DR: Recommendations focus on parameters for achieving reliable diagnosis and disease management and emphasize the critical role for complete surgical ablation in BIA-ALCL with lymph node involvement.
215 citations
TL;DR: Although many barriers stand in the way of calculating accurate estimates of the incidence and risk of developing BIA-ALCL, steady progress, international registries, and collegiality between research teams are for the first time allowing early estimates.
Abstract: Background:With breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) now accepted as a unique (iatrogenic) subtype of ALCL directly associated with textured breast implants, we are now at a point where a sound epidemiologic profile and risk estimate are required. The aim of this artic
166 citations
TL;DR: The assessment of a patient with suspected breast implant–associated anaplastic large cell lymphoma, the evaluation and diagnosis, the preoperative oncologic workup, the formation and execution of a surgical treatment plan, and the inclusion of adjunct treatments when indicated are presented.
Abstract: Learning Objectives:After reading this article, the participant should be able to: 1. Describe the diagnostic criteria for breast implant–associated (BIA) anaplastic large cell lymphoma (ALCL). 2. Appropriately evaluate a patient with suspected BIA-ALCL, including appropriate imaging, laboratory tes
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TL;DR: Copyright (©) 1999–2012 R Foundation for Statistical Computing; permission is granted to make and distribute verbatim copies of this manual provided the copyright notice and permission notice are preserved on all copies.
Abstract: Copyright (©) 1999–2012 R Foundation for Statistical Computing. Permission is granted to make and distribute verbatim copies of this manual provided the copyright notice and this permission notice are preserved on all copies. Permission is granted to copy and distribute modified versions of this manual under the conditions for verbatim copying, provided that the entire resulting derived work is distributed under the terms of a permission notice identical to this one. Permission is granted to copy and distribute translations of this manual into another language, under the above conditions for modified versions, except that this permission notice may be stated in a translation approved by the R Core Team.
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Book•
01 Jan 2003TL;DR: In this paper, a framework for investigating change over time is presented, where the multilevel model for change is introduced and a framework is presented for investigating event occurrence over time.
Abstract: PART I 1. A framework for investigating change over time 2. Exploring Longitudinal Data on Change 3. Introducing the multilevel model for change 4. Doing data analysis with the multilevel mode for change 5. Treating TIME more flexibly 6. Modelling discontinuous and nonlinear change 7. Examining the multilevel model's error covariance structure 8. Modelling change using covariance structure analysis PART II 9. A Framework for Investigating Event Occurrence 10. Describing discrete-time event occurrence data 11. Fitting basic Discrete-Time Hazard Models 12. Extending the Discrete-Time Hazard Model 13. Describing Continuous-Time Event Occurrence Data 14. Fitting Cox Regression Models 15. Extending the Cox Regression Model
8,435 citations
01 Jan 2016
TL;DR: This application applied longitudinal data analysis modeling change and event occurrence will help people to enjoy a good book with a cup of coffee in the afternoon instead of facing with some infectious virus inside their computer.
Abstract: Thank you very much for downloading applied longitudinal data analysis modeling change and event occurrence. As you may know, people have look hundreds times for their favorite novels like this applied longitudinal data analysis modeling change and event occurrence, but end up in malicious downloads. Rather than enjoying a good book with a cup of coffee in the afternoon, instead they are facing with some infectious virus inside their computer.
2,102 citations
University of Jordan1, Peter MacCallum Cancer Centre2, VU University Amsterdam3, Oakland University4, Columbia University5, Tufts University6, Emory University7, Harvard University8, University of Texas MD Anderson Cancer Center9, University of Houston10, Brown University11, Netherlands Cancer Institute12, American University of Beirut13
TL;DR: Most patients with breast implant-associated ALCL who had disease confined within the fibrous capsule achieved complete remission, justifying cytotoxic chemotherapy in addition to removal of implants.
Abstract: Purpose Breast implant‐associated anaplastic large-cell lymphoma (ALCL) is a recently described clinicopathologic entity that usually presents as an effusion-associated fibrous capsule surrounding an implant. Less frequently, it presents as a mass. The natural history of this disease and long-term outcomes are unknown.
351 citations
TL;DR: Surgical management with complete surgical excision is essential to achieve optimal event-free survival (EFS) and OS in patients with BI-ALCL.
Abstract: PurposeBreast implant–associated anaplastic large-cell lymphoma (BI-ALCL) is a rare type of T-cell lymphoma that arises around breast implants. The optimal management of this disease has not been established. The goal of this study is to evaluate the efficacy of different therapies used in patients with BI-ALCL to determine an optimal treatment approach.Patients and MethodsIn this study, we applied strict criteria to pathologic findings, assessed therapies used, and conducted a clinical follow-up of 87 patients with BI-ALCL, including 50 previously reported in the literature and 37 unreported. A Prentice, Williams, and Peterson model was used to assess the rate of events for each therapeutic intervention.ResultsThe median and mean follow-up times were 45 and 30 months, respectively (range, 3 to 217 months). The median overall survival (OS) time after diagnosis of BI-ALCL was 13 years, and the OS rate was 93% and 89% at 3 and 5 years, respectively. Patients with lymphoma confined by the fibrous capsule sur...
334 citations