Breast implant-associated anaplastic large cell lymphoma: sensitivity, specificity, and findings of imaging studies in 44 patients.

Abstract

UNLABELLED:

Breast implant-associated anaplastic large cell lymphoma (BIA ALCL) is a newly described clinicopathologic entity. The purpose of this study is to describe the imaging findings of patients with BIA ALCL and determine their sensitivity and specificity in the detection of the presence of an effusion or a mass related to BIA ALCL. A retrospective search was performed of our files as well as of the world literature for patients with pathologically proven BIA ALCL who had been assessed by any imaging study including ultrasound (US), computerized tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET)-CT, as well as mammography. The sensitivity and specificity of each imaging modality in the detection of an effusion or a mass around breast implants was determined. We identified 44 patients who had BIA ALCL and imaging studies performed between 1997 and 2013. The sensitivity for detecting an effusion was 84, 55, 82, and 38 %, and for detecting a mass was 46, 50, 50, and 64 %, by US, CT, MRI, and PET, respectively. The sensitivity of mammography in the detection of an abnormality without distinction of effusion or mass was 73 %, and specificity 50 %. Progression-free survival was worse in patients with an implant-associated mass (p = 0.001).

CONCLUSIONS:

Current imaging with US, CT, MR, and PET appears suboptimal in the detection of an imaging abnormality associated with BIA ALCL. This under diagnosis may reflect a lack of awareness of this rare entity suggesting the need for better understanding of the spectrum of imaging findings associated with BIA ALCL by breast imagers.

• Authors: Beatriz E Adrada, Roberto N Miranda, Gaiane Margishvili Rauch, Elsa Arribas, Rashmi Kanagal-Shamanna, Mark W Clemens, Michelle Fanale, Nisreen Haideri, Eid Mustafa, John Larrinaga, Neal R Reisman, Jesse Jaso, M James You, Ken H Young, L Jeffrey Medeiros, Wei Yang
• Journal: Breast cancer research and treatment (Breast Cancer Res Treat) Vol. 147 Issue 1 Pg. 1-14 (Aug 2014) ISSN: 1573-7217 [Electronic] Netherlands
• PMID: 25073777 (Publication Type: Journal Article, Review)

Topics

• Breast Implants (adverse effects)
• Breast Neoplasms (surgery)
• Clinical Trials as Topic
• Diagnostic Imaging
• Female
• Humans
• Lymphoma, Large-Cell, Anaplastic (diagnosis, etiology)
• Sensitivity and Specificity