Evaluating Breast Implants Characteristics and Replacements in BIA-ALCL Onset: A Multicenter Case-Control study.
Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is an uncommon malignancy caused by textured implants. Specific implant characteristics or replacement patterns were investigated in relation to BIA-ALCL onset.
In this multicenter, retrospective case-control study, data were collected from 327 women (39±13 years) with breast implants and no malignancy, and 94 age-matched BIA-ALCL cases (1:4 matching), across one U.S. and two European centers. Surgery indication, implant manufacturer, volume, surface texture, indwelling time, and history of replacements were analyzed. Associations with BIA-ALCL were assessed using conditional logistic regression analysis.
All BIA-ALCL cases were linked to implant roughness >10µm. Implant volume was positively associated with 81% higher likelihood of BIA-ALCL (OR per 100cc= 1.81, 95%CI [1.35, 2.44]). Breast reconstruction was associated with 47% lower odds of BIA-ALCL compared to cosmetic augmentations (OR= 0.53, 95%CI [0.33, 0.85]). One implant replacement was associated with 82% lower likelihood of BIA-ALCL compared to no replacement (OR= 0.18, 95%CI [0.10, 0.31]). Replacing from textured to smooth (OR= 0.06; 95% CI [0.013, 0.303]) or smooth to textured implants (OR= 0.06; 95% CI [0.013, 0.303]) had significantly lower likelihood of BIA-ALCL, compared to receiving another textured implant.
Study findings of no BIA-ALCL association to specific manufacturers or to implant roughness <10µm, support the evidence that surgeons and patients should consider breast implant roughness in treatment decisions among primary or secondary asymptomatic patients.
In this multicenter, retrospective case-control study, data were collected from 327 women (39±13 years) with breast implants and no malignancy, and 94 age-matched BIA-ALCL cases (1:4 matching), across one U.S. and two European centers. Surgery indication, implant manufacturer, volume, surface texture, indwelling time, and history of replacements were analyzed. Associations with BIA-ALCL were assessed using conditional logistic regression analysis.
All BIA-ALCL cases were linked to implant roughness >10µm. Implant volume was positively associated with 81% higher likelihood of BIA-ALCL (OR per 100cc= 1.81, 95%CI [1.35, 2.44]). Breast reconstruction was associated with 47% lower odds of BIA-ALCL compared to cosmetic augmentations (OR= 0.53, 95%CI [0.33, 0.85]). One implant replacement was associated with 82% lower likelihood of BIA-ALCL compared to no replacement (OR= 0.18, 95%CI [0.10, 0.31]). Replacing from textured to smooth (OR= 0.06; 95% CI [0.013, 0.303]) or smooth to textured implants (OR= 0.06; 95% CI [0.013, 0.303]) had significantly lower likelihood of BIA-ALCL, compared to receiving another textured implant.
Study findings of no BIA-ALCL association to specific manufacturers or to implant roughness <10µm, support the evidence that surgeons and patients should consider breast implant roughness in treatment decisions among primary or secondary asymptomatic patients.
Authors
Santanelli di Pompeo Santanelli di Pompeo, Panagiotakos Panagiotakos, Clemens Clemens, Firmani Firmani, Kolasiński Kolasiński, Sorotos Sorotos
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