Doren Erin L, Miranda Roberto N, Selber Jesse C, Garvey Patrick B, Liu Jun, Medeiros L Jeffrey, Butler Charles E, Clemens Mark W
Milwaukee, Wis.; and Houston, Texas.
From the Department of Plastic Surgery, Medical College of Wisconsin, Tosa Center; and the Departments of Hematopathology and Plastic Surgery, The University of Texas M. D. Anderson Cancer Center.
Plast Reconstr Surg. 2017 May;139(5):1042-1050. doi: 10.1097/PRS.0000000000003282.
Breast implant-associated anaplastic large cell lymphoma (ALCL) is a distinctive type of T-cell lymphoma that arises around breast implants. Although rare, all cases with adequate history have involved a textured breast implant. The objective of this study was to determine the U.S. incidence and lifetime prevalence of breast implant-associated ALCL in women with textured breast implants.
This is a retrospective review of documented cases of breast implant-associated ALCL in the United States from 1996 to 2015. The incidence and prevalence were determined based on a literature and institutional database review of breast implant-associated ALCL cases and textured breast implant sales figures from implant manufacturers' annualized data.
One hundred pathologically confirmed breast implant-associated ALCL cases were identified in the United States. Mean age at diagnosis was 53.2 ± 12.3 years. Mean interval from implant placement to diagnosis was 10.7 ± 4.6 years. Forty-nine patients had breast implants placed for cosmetic reasons, 44 for mastectomy reconstruction, and seven for unknown reasons. Assuming that breast implant-associated ALCL occurs only in textured breast implants, the incidence rate is 2.03 per 1 million person-years (203 per 100 million person-years), which is 67.6 times higher than that of primary ALCL of the breast in the general population (three per 100 million per year; p < 0.001). Lifetime prevalence was 33 per 1 million persons with textured breast implants.
This study demonstrates a statistically significant association between textured breast implants and breast implant-associated ALCL. Although women with a textured breast implant have a low risk of developing breast implant-associated ALCL, the current U.S. incidence is significantly higher than that of primary ALCL of the breast in the general population.
乳房植入物相关间变性大细胞淋巴瘤（ALCL）是一种在乳房植入物周围发生的独特类型的T细胞淋巴瘤。尽管罕见，但所有有充分病史的病例均涉及有纹理的乳房植入物。本研究的目的是确定有纹理乳房植入物的女性中乳房植入物相关ALCL在美国的发病率和终生患病率。
这是一项对1996年至2015年美国有记录的乳房植入物相关ALCL病例的回顾性研究。发病率和患病率是基于对乳房植入物相关ALCL病例的文献和机构数据库回顾以及植入物制造商年度数据中的有纹理乳房植入物销售数字确定的。
在美国共识别出100例经病理证实的乳房植入物相关ALCL病例。诊断时的平均年龄为53.2±12.3岁。从植入到诊断的平均间隔时间为10.7±4.6年。49例患者因美容原因植入乳房植入物，44例因乳房切除术后重建，7例原因不明。假设乳房植入物相关ALCL仅发生在有纹理的乳房植入物中，发病率为每100万人年2.03例（每1亿人年203例），这比普通人群中原发性乳房ALCL的发病率高67.6倍（每年每1亿人3例；p<0.001）。有纹理乳房植入物的女性终生患病率为每100万人33例。
本研究表明有纹理的乳房植入物与乳房植入物相关ALCL之间存在统计学上的显著关联。尽管有纹理乳房植入物的女性发生乳房植入物相关ALCL的风险较低，但目前美国的发病率明显高于普通人群中原发性乳房ALCL的发病率。
