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“A Prospective Approach to Inform and Treat 1,340 Patients at Risk for BIA-ALCL.”

Roberts, John M MD1; Carr, Logan W MD1; Jones, Allison BSN1; Schilling, Amber PharmD, Med1; Mackay, Donald R. MD DDS1; Potochny, John D MD1

Plastic and Reconstructive Surgery: April 9, 2019 - Volume PRS Online First - Issue - p
doi: 10.1097/PRS.0000000000005703
Special Topic: PDF Only

Background: Breast implant-associated anaplastic large cell lymphoma’s increasing incidence and associated mortality 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.

Methods: All patients who had breast implants placed at Penn State Hershey Medical Center from 1979 to November 2017 were mailed a letter to describe BIA-ALCL and to encourage a follow-up visitation. Patient information regarding demographics, implant type, the number of calls and follow up visits, physical exam findings, as well as patient decisions after being informed of the disease were recorded prospectively.

Results: One thousand two hundred and eighty-four letters were mailed with 1,020 (79.4%) to patients with smooth implants and 264 (20.6%) with textured implants. Seventy-six calls were received and 100 patients (84 smooth, 16 textured) were evaluated within the first two months. Of the 16 patients with textured implants, nine are undergoing secondary surgery to remove or replace their textured device.

Conclusions: Informing patients at risk for breast implant-associated anaplastic large cell lymphoma 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 as well as decrease mortality. We provide a method, supporting documents and preliminary data to help other institutions contact their breast implant patients at risk for BIA-ALCL.

1. Department of Surgery, Division of Plastic Surgery, Pennsylvania State University, College of Medicine, Hershey, PA.

Financial Disclosure Statement: The authors have no financial conflicts to disclose.

Acknowledgements: For clinical support- Pat Drobnick

Corresponding Author: John D Potochny, MD, The Pennsylvania State University, College of Medicine, Division of Plastic Surgery, H071, 500 University Drive, Hershey, PA 17033, Tel #: 717-531-4390, Fax #: 717-531-4339, E-mail:

©2019American Society of Plastic Surgeons