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Published on: February 6, 2020
The Risk of Breast Implant-Associated Anaplastic Large Cell Lymphoma; A Systematic Review and Meta-Analysis
Ali Mohamed Elameen1, Mohamed Awad AlMarakby2, Tarek Ibrahim Atta3
1Department of Plastic and Reconstructive Surgery, El-Sahel Teaching Hospital, Cairo, Egypt.
Background:
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an emerging disorder that has gained global attention throughout the past era. The present meta-analysis was performed to retrieve the risk of BIA-ALCL from population-based epidemiological studies. Factors associated with BIA-ALCL were evaluated to identify patients at higher risk of BIA-ALCL.
Methods:
A systematic literature search was executed throughout 12 databases. All epidemiological studies encompassing patients with breast implants either for aesthetic or reconstructive purposes and reported the risk of BIA-ALCL were included. Studies reported the risk factors of BIA-ALCL were included.
Results:
The present meta-analysis included 17 articles, encompassing 525,475 patients with breast implants. There were 254 patients with BIA-ALCL with a mean duration to the diagnosis of BIA-ALCL of 13.16 years (95% CI 11.7-14.6, P < 0.001). There were 44 patients with textured breast implants and two with smooth implants. Patients with breast implants were 28.86 times more at high risk of BI-ALCL (95% CI 3.123-266.681). The risk ranged from 0 to 1 per 1000 cases with breast implants, with a similar risk among patients seeking aesthetic and reconstructive surgeries. The risk was 0 to 1 case per 1000 cases among patients with textured breast implants. There was a significant association between the history of breast cancer and BIA-ALCL (P = 0.0016).
Conclusion:
This meta-analysis confirmed the association between breast implants and ALCL. There was a similar risk of BIA-ALCL among patients with aesthetic or reconstructive surgeries. Patients with a history of breast cancer were at higher risk of BIA-ALCL.
Level Of Evidence Iii:
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

