Estimating the Prevalence of Breast Implant-Associated Anaplastic Large-Cell Lymphoma: A Systematic Review.

Background: Assessment of breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) prevalence is challenged by a lack of population-level data for the prevalence of breast implants in the wider population. Absence of such data obscures the true prevalence of BIA-ALCL and hinders informed consent consultations. The authors performed a systematic review to synthesize data from published studies reporting BIA-ALCL cases in defined patient populations to better inform the evidence base.

Methods: PubMed and Embase were searched to obtain studies reporting the prevalence of BIA-ALCL in defined patient cohorts with breast implants where case prevalence was calculable. Study characteristics, the number of BIA-ALCL cases, and total sample size were extracted and used to calculate the prevalence of BIA-ALCL per 100,000 implanted patients.

Results: Of 1477 publications identified by the search, 38 studies incorporating 28 cohort and 6 registry studies satisfied the inclusion criteria, encompassing a total population sample of 17,038,371 patients and 1170 BIA-ALCL cases. The prevalence of BIA-ALCL was found to be 30.54 per 100,000 implanted patients with textured implants (1 case per 3274 implanted patients) and 6.70 per 100,000 implanted patients with implants of any type (1 case per 14,925 implanted patients).

Conclusions: By synthesizing the published literature, this work provides a determination of BIA-ALCL prevalence using study- and population-level data where the prevalence of breast implants is known. The accurate determination of BIA-ALCL prevalence is of fundamental importance for patients undergoing implant-related surgery to enable the provision of valid informed consent.