Elameen Ali Mohamed, AlMarakby Mohamed Awad, Atta Tarek Ibrahim, Dahy Asmaa Ali
Department of Plastic and Reconstructive Surgery, El-Sahel Teaching Hospital, Cairo, Egypt.
Department of Plastic and Reconstructive Surgery, Faculty of Medicine For Girls, Al-Azhar University, Gameat Al Azhar, Nasr City, Cairo, Egypt.
Aesthetic Plast Surg. 2024 Dec;48(24):5315-5328. doi: 10.1007/s00266-024-03956-9. Epub 2024 May 9.
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.
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.
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).
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.
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 .
乳房植入物相关间变性大细胞淋巴瘤（BIA-ALCL）是一种在过去一段时间内受到全球关注的新出现的疾病。本荟萃分析旨在从基于人群的流行病学研究中获取BIA-ALCL的风险。对与BIA-ALCL相关的因素进行评估，以识别BIA-ALCL风险较高的患者。
在12个数据库中进行了系统的文献检索。纳入所有涉及出于美容或重建目的植入乳房植入物的患者并报告了BIA-ALCL风险的流行病学研究。纳入报告了BIA-ALCL危险因素的研究。
本荟萃分析纳入了17篇文章，涵盖525475例乳房植入物患者。有254例BIA-ALCL患者，BIA-ALCL诊断的平均时长为13.16年（95%CI 11.7-14.6，P<0.001）。有44例使用毛面乳房植入物的患者，2例使用光面植入物的患者。乳房植入物患者发生BI-ALCL的高风险是普通人群的28.86倍（95%CI 3.123-266.681）。风险范围为每1000例乳房植入物患者中有0至1例，在寻求美容手术和重建手术的患者中风险相似。毛面乳房植入物患者中每1000例有0至1例。乳腺癌病史与BIA-ALCL之间存在显著关联（P=0.0016）。
本荟萃分析证实了乳房植入物与ALCL之间的关联。美容手术或重建手术患者发生BIA-ALCL的风险相似。有乳腺癌病史的患者发生BIA-ALCL的风险更高。
证据级别III：本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
