From the Department of Surgery, Division of Plastic Surgery, Pennsylvania State University, College of Medicine.
Plast Reconstr Surg. 2019 Jul;144(1):46-54. doi: 10.1097/PRS.0000000000005703.
The increasing incidence and associated mortality of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) has become alarming. However, many patients remain unaware of their risk for BIA-ALCL and may overlook early warning signs of the cancer. The authors aim to contact all breast implant patients at a single institution to educate them on the disease and provide screening and treatment as indicated.
All patients who had breast implants placed at Penn State Hershey Medical Center from 1979 to November of 2017 were mailed a letter to describe BIA-ALCL and to encourage a follow-up visit. Patient information regarding demographics, implant type, the number of calls and follow-up visits, physical examination findings, and patient decisions after being informed of the disease were recorded prospectively.
One thousand two hundred eighty-four letters were mailed to 1020 patients (79.4 percent) with smooth implants and 264 patients (20.6 percent) with textured implants. Seventy-six calls were received and 100 patients (84 smooth and 16 textured) were evaluated within the first 2 months. Of the 16 patients with textured implants, nine are undergoing secondary surgery to remove or replace their textured device.
Informing patients at risk for BIA-ALCL is an important endeavor. Patients educated on the disease will likely be diagnosed and treated earlier, which can prevent the need for adjuvant chemotherapy and/or radiation therapy and decrease mortality. The authors provide a method, supporting documents, and preliminary data to help other institutions contact their breast implant patients at risk for BIA-ALCL.
乳腺植入物相关间变性大细胞淋巴瘤（BIA-ALCL）的发病率和相关死亡率不断上升，令人担忧。然而，许多患者仍然不知道自己患 BIA-ALCL 的风险，可能会忽略癌症的早期预警信号。作者旨在联系一家机构的所有乳腺植入物患者，对他们进行疾病教育，并根据需要进行筛查和治疗。
将 1979 年至 2017 年 11 月在宾夕法尼亚州立大学赫尔希医疗中心接受乳腺植入物的所有患者寄信，描述 BIA-ALCL，并鼓励他们进行随访。前瞻性记录患者的人口统计学、植入物类型、电话和随访次数、体格检查结果以及在了解疾病后做出的决策等信息。
向 1020 名接受光滑植入物的患者（79.4%）和 264 名接受纹理植入物的患者（20.6%）寄出了 1284 封信。收到 76 个电话，前两个月评估了 100 名患者（84 名光滑，16 名纹理）。在 16 名接受纹理植入物的患者中，9 名正在接受二次手术以去除或更换他们的纹理设备。
告知 BIA-ALCL 风险患者是一项重要的努力。接受疾病教育的患者可能会更早被诊断和治疗，从而避免辅助化疗和/或放疗的需要，并降低死亡率。作者提供了一种方法、支持文件和初步数据，以帮助其他机构联系其患有 BIA-ALCL 的乳腺植入物患者。
