ALCL door implantaten
Wat is ALCL (Anaplastic Large Cell Lymphoma)
Dit is een zeldzame vorm van Non Hodgkin lymfoom (lymfeklierkanker) die in verband is gebracht met het dragen van borstimplantaten. Daarom wordt het ook wel BIA-ALCL genoemd (Breast Implant Associated Anaplastic Large Cell Lymphoma) Het is een kanker van het immuunsysteem. Het gaat meestal om de T-cellen, maar soms ook om de B-cellen.
Vrouwen met getextureerde/geruwde siliconen - of zoutwater implantaten hebben een verhoogde kans op ALCL. Het ontstaat vaak in het kapsel van de implantaten in de borst en soms in de oksel. ALCL komt veel minder voor bij vrouwen die geen implantaten hebben.
Volgens onderzoek van plastisch chirurg Mintsje de Boer komt het ca. 1 op 7.000 vrouwen met implantaten voor. >>
Symptomen
Bij deze symptomen kun je aan ALCL denken: (soms nog jaren nadat de borstimplantaten zijn geplaatst)
Zwelling van de borst door vocht (seroma)
Pijn in de borst
Knobbels
Asymmetrie van de borsten
Hoe wordt diagnose gesteld
Via een punctie van het vocht (seroma) kan de diagnose ALCL worden gesteld.
Daarnaast ook een echo of MRI.
Werkprotocol ALCL van de NVPC >>
Behandeling
De implantaten moeten zo snel mogelijk verwijderd worden. Daarna volgt meestal chemo en/of bestraling. Elke 6 maanden 5 jaar lang onderzoek nodig volgens de FDA >>
Hoe groot is de kans op ALCL
Volgens de IGJ hebben vrouwen met implantaten 400 keer een verhoogde kans op ALCL en zeggen ze dat de kans 1 op 7.000 is dat je het krijgt tegen de tijd dat je 75 jaar bent. ECHTER... de kans is vele malen hoger volgens deze onderzoeken:
Volgens dit onderzoek uit 2020 is de kans 1 op 355 vrouwen (en 602 implantaten) >>
Dit onderzoek uit 2023 beschrijft een kans 1 op 914 >>
Meer onderzoeken en cijfers hieronder bij 'wetenschappelijke onderzoeken'
Aantal
In Nederland zijn er inmiddels al 91 vrouwen met ALCL. Tussen 1996 en 2018 waren het er 52. Vanaf 2018 zien we een flinke stijging.
Volgens de officiële cijfers in de literatuur gaat het wereldwijd om 200 patiënten. Dit is niet correct.
67 vrouwen in Nederland - 2 overleden juli 2019 >>
In de VS zijn er 359 gevallen bekend >>, in Frankrijk 29 maar vermoedelijk veel meer omdat het in vergelijking tot NL een veel groter land is.
Volgens het Franse Kankerinstituut gaat het om 1 - 2 per 100.000 vrouwen met implantaten >>
De Nederlandse Vereniging voor Plastisch Chirurgen beweerde in 2015; 1 op de 500.000 tot 1 op de 3.000.000 >>
Nederlands onderzoek wijst uit 1 op de 25.000 (2017) >>
De TGA in Australië zegt over het aantal: Current expert opinion puts the risk of ALCL at between 1-1.000 - in 10.000 >>
Bij het Meldpunt zijn 8 vrouwen bekend, waarvan 2 meldingen in 2017.
Patiëntenvereniging
Patiëntenvereniging Hematon >>
Jaren na explantatie ALCL in kapsel
Uit dit onderzoek blijkt dat 4 jaar na het verwijderen van implantaten, ALCL in het niet verwijderde kapsel werd gevonden. 2015 >> Het onderschrijft het belang van kapselverwijdering.
Nieuws
Lymfeklierkanker bij borstprotheses heel erg zeldzaam. dec 2021 >>
FDA waarschuwt: Alle implantaten kunnen lymfeklierkanker veroorzaken. febr 2019 >>
Grotere kans op kankersoort ALCL door siliconen borstimplantaten. jan 2018 >>
43 vrouwen in Nederland, waarvan het laatste jaar 11. Een sterk stijgend percentage.
Rare cancer reignites debate over breast implants' safety 7 juli 2017 >>
9 deaths and rare cancer linked to breast implants, FDA says 22 maart 2017 >>
FDA waarschuwt voor ALCL maart 2017 >>
Wetenschappelijke onderzoeken
BIA ALCL: Breast Implant Associated Anaplastic Large-Cell lymphoma / Anaplastisch Grootcellig Lymfoom, is een vorm van Non Hodgkin lymfoom, die geassocieerd wordt met borstimplantaten.
Breast Implant-Associated Tumors. 2023 >>
Breast Implant Anaplastic Large Cell Lymphoma (BIAALCL): A Systematic Review and Case Report Regarding Incidence and Pathology Workup 2023 >>
Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma in the United States: A Systematic Review. 2023 >>
The evaluation of the delayed swollen breast in patients with a history of breast implants >> 2023
Breast Implant-associated Anaplastic Large Cell Lymphoma after Breast Reconstruction for Breast Cancer. 2023 >>
Current Progress in Breast Implant-Associated Anaplastic Large Cell Lymphoma. 2022 >> (vertaling >>)
Clinical Implications and Management of Non-ALCL Breast Implant Capsular Pathology. 2022 >>
Breast Implant-Associated Anaplastic Large Cell Lymphoma in Brazil: What Are We Missing? 2022 >>
Concerns Regarding Dishonesty in Reporting a Large Study of Patients Treated With Allergan Biocell Breast Implants. 2022 >>
Textured and Smooth Implant Use Reported in the Tracking Operations and Outcomes for Plastic Surgeons Database: Epidemiologic Implications for BIA-ALCL. 2021 >>
Management of Symptomatic Patients with Textured Implants. Bij figuur 7 staat dat een vrouw na 6 jaar na explantatie nog ALCL kreeg. 2021 >>
Risk of Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) in a Cohort of 3546 Women Prospectively Followed Long Term After Reconstruction with Textured Breast Implants. 2020 >>
Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL): An Open Wound. 2020 >>
Lymfklierkanker door borstprothesen? 2020 >>
Synchronous breast implant associated anaplastic large cell lymphoma (BIA-ALCL) and silicone induced granuloma of breast implant capsule (SIGBIC): What to learn. 2020 >>
Breast Implant-Associated Anaplastic Large Cell Lymphoma: What the Primary Care Physician Needs to Know. 2020 >>
Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia: A Longitudinal Study of Implant and Other Related Risk Factors. 2020 >>
Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Prospective Series of 52 Patients. 2020 >>
Best Practices Guideline for the Pathologic Diagnosis of Breast Implant–Associated Anaplastic Large-Cell Lymphoma. 2020 >>
Current Risk Estimate of Breast Implant–Associated Anaplastic Large Cell Lymphoma in Textured Breast Implants. 2020 >>
Stepwise En Bloc Resection of Breast Implant-Associated Anaplastic Large Cell Lymphoma with Oncologic Considerations. 2019 >>
Breast Implant–Associated Anaplastic Large Cell Lymphoma: What We Know. 2019 >>
Synchronous Breast Implant–associated Anaplastic Large Cell Lymphoma and Invasive Carcinoma: Genomic Profiling and Management Implications. 2019 >>
1st World Consensus Conference on BIA-ALCL. 2019 >>
The Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand Confirms the Highest Risk for Grade 4 Surface Breast Implants.2019 >>
A Rare Case of a Transgender Female With Breast Implant–Associated Anaplastic Large Cell Lymphoma Treated With Radiotherapy and a Review of the Literature. 2019 >>
Microbial detection in seroma fluid preceding the diagnosis of breast implant-associated anaplastic large cell lymphoma: a case report and review of the literature. 2019 >>
Stepwise En Bloc Resection of Breast Implant-Associated Anaplastic Large Cell Lymphoma with Oncologic Considerations. 2019 >>
The First Reported Case of Gluteal Implant-Associated Anaplastic Large Cell Lymphoma (ALCL) 2019 >>
IL-13 is produced by tumor cells in Breast Implant Associated Anaplastic Large Cell Lymphoma: Implications for pathogenesis. 2018 >>
Breast Implant-Associated Anaplastic Large Cell Lymphoma With Bone Marrow Involvement. 2018 >>
Breast Implant-Associated Bilateral B-Cell Lymphoma. 2018 >>
Breast implants and the risk of ALCL in the breast. 2018 >>
The Diagnosis and Treatment of a New Disease Entity. 2018 >>
How to diagnose and treat breast implant associated ALCL. 2018 >>
Silicone-induced granuloma of breast implant capsule (SIGBIC): similarities and differences with anaplastic large cell lymphoma (ALCL) and their differential diagnosis. 2017 >>
Macrotextured Breast Implants with Defined Steps to Minimize Bacterial Contamination around the Device: Experience in 42,000 Implants. 2017 >>
Breast Implant–Associated Anaplastic Large Cell Lymphoma. A Systematic Review. 2017 >>
Breast implant-associated anaplastic large cell lymphoma: A review and assessment of cutaneous manifestations. 2017 >>
Breast Implant-Associated Anaplastic Large-Cell Lymphoma in a Transgender Woman. 2017 >>
Breast implant associated Anaplastic Large Cell Lymphoma in Australia and New Zealand - high surface area textured implants are associated with increased risk. 2017 >>
Axillaire disseminatie bij BIA-ALCL; waarom klinische awareness van belang is (NVPC 2016) >>
Biomarkers Provide Clues to Early Events in the Pathogenesis of Breast Implant-Associated Anaplastic Large Cell Lymphoma. 2016 >>
Breast Implant-Associated Anaplastic Large Cell Lymphoma: Two Distinct Clinicopathological Variants with Different Outcomes. 2016 >>
Complete Surgical Excision is Essential for the Management of Patients with Breast Implant Associated Anaplastic Large-Cell Lymphoma. 2016 >>
Breast Implant Informed Consent Should Include the Risk of Anaplastic Large Cell Lymphoma. 2016 >>
The 2016 Revision of the World Health Organization Classification of Lymphoid Neoplasms. 2016 >>
Bacterial Biofilm Infection Detected in Breast Implant–Associated Anaplastic Large-Cell Lymphoma. 2016 >>
Breast Implant Informed Consent Should Include the Risk of Anaplastic Large Cell Lymphoma. 2016 >>
Biomarkers Provide Clues to Early Events in the Pathogenesis of Breast Implant-Associated Anaplastic Large Cell Lymphoma. 2016 >>
Bacterial biofilm infection detected in breast implant associated anaplastic large cell lymphoma. 2016 >>
Breast Implant Associated Anaplastic Large cell Lymphoma: two distinct clinicopathological variants with different outcomes. 2015 >>
Complete Surgical Excision Is Essential for the Management of Patients With Breast Implant–Associated Anaplastic Large-Cell Lymphoma. 2015 >>
Breast implant-associated anaplastic large-cell lymphoma. 2015 >>
The non-specific symptoms of breast implant-associated anaplastic large cell lymphoma resulting in delayed diagnosis: a case-based review. 2015 >>
Breast Implant–associated Anaplastic Large Cell Lymphoma: updated results from a structured expert consultation process. 2015 >>
Commentary on: Lymphomas Associated With Breast Implants: A Review of the Literature. 2015 >>
Anaplastic Large Cell Lymphoma Occurring in Women with Breast Implants: Analysis of 173 Cases. 2015 >>
Breast Implant-Associated Anaplastic Large Cell Lymphoma: Updated Results from a Structured Expert Consultation Process. 2015 >>
Chronic Biofilm Infection in Breast Implants is Associated with an Increased T-Cell Lymphocytic Infiltrate: Implications for Breast Implant-Associated Lymphoma. 2015 >>
Coming of Age Breast Implant-Associated Anaplastic Large Cell Lymphoma After18 Years of Investigation. 2015 >>
Anaplastic large cell lymphoma (ALCL) and breast implants: Breaking down the evidence. 2014 >>
Breast Implant-Associated Anaplastic Large Cell Lymphoma: Sensitivity, Specificity, and Findings of Imaging Studies in 44 Patients. 2014 >>
Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients. 2014 .>>
Breast Implant-Associated ALCL: A Unique Entity in the Spectrum of CD30 Lymphoproliferative Disorders. 2014 >>
Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Systematic Review of the Literature and Mini-Meta Analysis. 2013 >>
Breast implant associated ALK negative anaplastic large cell lymphoma; a case report and discussion of possible pathogenesis. 2013 >>
Anaplastic large cell lymphoma occurring in association with breast implants: review of pathologic and immunohistochemical features in 103 cases. 2013 >>
Anaplastic lymphoma masquerading as breast abscess in a patient with silicone implants. 2013 >>
Anaplastic large cell lymphoma and breast implants: five Australian cases. 2012 >>
Anaplastic Large Cell Lymphoma Associated With Breast Implants: A Report of 13 Cases. 2012 >>
Anaplastic large cell lymphoma and breast implants 2011 >>
Managing Late Periprosthetic Fluid Collections (Seroma) in Patients with Breast Implants: A Consensus Panel Recommendation and Review of the Literature. 2011 >>
A Patient Death Attributable to Implant-Related Primary Anaplastic Large Cell Lymphoma of the Breast. 2011 >>
FDA; Anaplastic Large Cell Lymphoma (ALCL) In Women with Breast Implants: Preliminary FDA Findings and Analyses. 2011 >>
Reactie van de Amerikaanse 'Breast Cancer Action": ' BCA has long advocated that we must stop putting products in the marketplace before we fully understand their potential impact on human health.In this case, the studies that identified that women with breast implants have a small but increased risk of ALCL were conducted in post approval monitoring – after approved implants were surgically placed in women’s bodies. BCA will continue to urge the FDA to put patients first and have health data before approving medical devices.'
Primary breast lymphoma in a patient with silicone breast implants: a case report and review of the literature. 2009 >>
Anaplastic large-cell lymphoma in women with breast implants. 2008 >>
Seroma-associated primary anaplastic large-cell lymphoma adjacent to breast implants: an indolent T-cell lymphoproliferative disorder. 2008 >>
Breast lymphoma associated with breast implants: two case-reports and a review of the literature. 2002 >>
