Nagura Naomi, Kida Kumiko, Yumura Chika, Yamauchi Hideko
From the Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2024 Sep 3;12(9):e6113. doi: 10.1097/GOX.0000000000006113. eCollection 2024 Sep.
When a delayed seroma with a low volume is detected more than 1 year after silicone breast implant insertion, aspiration is necessary. However, if the seroma is small and difficult to collect, we may avoid puncturing it, considering the risk of damaging the implant, and the patient may be followed up intensively. Moreover, a delayed seroma is a major symptom of breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL). We encountered a case in which a delayed seroma around a breast implant was punctured to rule out BIA-ALCL after nipple-sparing mastectomy for breast cancer, which led to the diagnosis of locoregional recurrence in the nipple areola. Based on this experience, we suggest that puncture cytology for fluid around breast implants should be performed when a delayed seroma is observed, as it may indicate breast cancer recurrence as well as BIA-ALCL.
在硅胶乳房植入术后1年以上发现少量延迟性血清肿时,需要进行抽吸。然而,如果血清肿较小且难以抽取,考虑到有损坏植入物的风险,我们可能会避免穿刺,对患者进行密切随访。此外,延迟性血清肿是乳房植入物相关间变性大细胞淋巴瘤(BIA-ALCL)的主要症状。我们遇到过这样一个病例,在乳腺癌保乳乳房切除术后,为排除BIA-ALCL而对乳房植入物周围的延迟性血清肿进行穿刺,结果导致乳头乳晕局部复发的诊断。基于这一经验,我们建议,当观察到延迟性血清肿时,应对乳房植入物周围的液体进行穿刺细胞学检查,因为这可能提示乳腺癌复发以及BIA-ALCL。