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The Epidemiology of Breast Implant–Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand Confirms the Highest Risk for Grade 4 Surface Breast Implants

Magnusson, Mark F.R.A.C.S.; Beath, Kenneth Ph.D.; Cooter, Rodney F.R.A.C.S.; Locke, Michelle F.R.A.C.S.; Prince, H. Miles Ph.D., F.R.A.C.P.; Elder, Elisabeth F.R.A.C.S.; Deva, Anand K. B.Sc.(Med.), M.S., F.R.A.C.S.

Plastic and Reconstructive Surgery: May 2019 - Volume 143 - Issue 5 - p 1285-1292
doi: 10.1097/PRS.0000000000005500
Breast: Original Articles
Patient Safety CME

Background: The epidemiology and implant-specific risk for breast implant–associated (BIA) anaplastic large cell lymphoma (ALCL) has been previously reported for Australia and New Zealand. The authors now present updated data and risk assessment since their last report.

Methods: New cases in Australia and New Zealand were identified and analyzed. Updated sales data from three leading breast implant manufacturers (i.e., Mentor, Allergan, and Silimed) were secured to estimate implant-specific risk.

Results: A total of 26 new cases of BIA-ALCL were diagnosed between January of 2017 and April of 2018, increasing the total number of confirmed cases in Australia and New Zealand to 81. This represents a 47 percent increase in the number of reported cases over this period. The mean age and time to development remain unchanged. The implant-specific risk has increased for Silimed polyurethane (23.4 times higher) compared with Biocell, which has remained relatively static (16.5 times higher) compared with Siltex implants.

Conclusions: The number of confirmed cases of BIA-ALCL in Australia and New Zealand continues to rise. The implant-specific risk has now changed to reflect a strong link to implant surface area/roughness as a major association with this cancer.

Patient Safety CME.

Macquarie Park and Sydney, New South Wales, and Melbourne, Victoria, Australia

From Griffith University; the Australian Joint BIA-ALCL Task Force; Macquarie University; Monash University, Australian Breast Device Registry; the New Zealand Association of Plastic Surgeons; Epworth Healthcare, Sir Peter MacCallum Cancer Center and Department of Oncology, University of Melbourne; the Westmead Breast Cancer Institute, Breast Surgeons in Australia & New Zealand; and the Integrated Specialist Healthcare Education and Research Foundation.

Received for publication May 25, 2018; accepted September 13, 2018.

Disclosure:Professor Deva is a consultant, educator, and research coordinator for Mentor (J&J), Allergan, Motiva, Sientra, and Acelity. Professor Magnusson is a consultant and educator for Mentor (J&J) and Allergan. The remaining authors have no financial interest to declare in relation to the content of this article.

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Anand K. Deva, B.Sc.(Med.), M.S., F.R.A.C.S., Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Suite 301, 2 Technology Place, Sydney, New South Wales, Australia,, Twitter: @saferimplants, Instagram: @profdeva

Copyright © 2019 by the American Society of Plastic Surgeons