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Monalisa Sur - One of the best experts on this subject based on the ideXlab platform.
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Primary anaplastic large cell lymphoma of the Breast arising in reconstruction mammoplasty capsule of saline filled Breast Implant after radical mastectomy for Breast cancer: an unusual case presentation
Diagnostic Pathology, 2009Co-Authors: Mona Ry Bishara, Cathy Ross, Monalisa SurAbstract:Background Primary non-Hodgkin lymphoma (NHL) of the Breast represents 0.04–0.5% of malignant lesions of the Breast and accounts for 1.7–2.2% of extra-nodal NHL. Most primary cases are of B-cell phenotype and only rare cases are of T-cell phenotype. Anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma typically seen in children and young adults with the Breast being one of the least common locations. There are a total of eleven cases of primary ALCL of the Breast described in the literature. Eight of these cases occurred in proximity to Breast Implants, four in relation to silicone Breast Implant and three in relation to saline filled Breast Implant with three out of the eight Implant related cases having previous history of Breast cancer treated surgically. Adjuvant postoperative chemotherapy is given in only one case. Secondary hematological malignancies after Breast cancer chemotherapy have been reported in literature. However in contrast to acute myeloid leukemia (AML), the association between lymphoma and administration of chemotherapy has never been clearly demonstrated. Case Presentation In this report we present a case of primary ALCL of the Breast arising in reconstruction mamoplasty capsule of saline filled Breast Implant after radical mastectomy for infiltrating ductal carcinoma followed by postoperative chemotherapy twelve years ago. Conclusion Primary ALK negative ALCL arising at the site of saline filled Breast Implant is rare. It is still unclear whether chemotherapy and Breast Implantation increases risk of secondary hematological malignancies significantly. However, it is important to be aware of these complications and need for careful pathologic examination of tissue removed for Implant related complications to make the correct diagnosis for further patient management and treatment. It is important to be aware of this entity at this site as it can be easily misdiagnosed on histologic grounds and to exclude sarcomatoid carcinoma, malignant melanoma and pleomorphic sarcoma by an appropriate panel of immunostains to arrive at the correct diagnosis of ALCL.
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primary anaplastic large cell lymphoma of the Breast arising in reconstruction mammoplasty capsule of saline filled Breast Implant after radical mastectomy for Breast cancer an unusual case presentation
Diagnostic Pathology, 2009Co-Authors: Mona Ry Bishara, Catherine Ross, Monalisa SurAbstract:Background Primary non-Hodgkin lymphoma (NHL) of the Breast represents 0.04–0.5% of malignant lesions of the Breast and accounts for 1.7–2.2% of extra-nodal NHL. Most primary cases are of B-cell phenotype and only rare cases are of T-cell phenotype. Anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma typically seen in children and young adults with the Breast being one of the least common locations. There are a total of eleven cases of primary ALCL of the Breast described in the literature. Eight of these cases occurred in proximity to Breast Implants, four in relation to silicone Breast Implant and three in relation to saline filled Breast Implant with three out of the eight Implant related cases having previous history of Breast cancer treated surgically. Adjuvant postoperative chemotherapy is given in only one case. Secondary hematological malignancies after Breast cancer chemotherapy have been reported in literature. However in contrast to acute myeloid leukemia (AML), the association between lymphoma and administration of chemotherapy has never been clearly demonstrated.
Lisbet Rosenkrantz Hölmich - One of the best experts on this subject based on the ideXlab platform.
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the diagnosis of silicone Breast Implant rupture clinical findings compared with findings at magnetic resonance imaging
Annals of Plastic Surgery, 2005Co-Authors: Lisbet Rosenkrantz Hölmich, Jon P. Fryzek, Kim Kjøller, Vibeke Breiting, Anna Jorgensen, Christen Krag, Joseph K. MclaughlinAbstract:Abstract:The objective was to evaluate the usefulness of clinical examination in the evaluation of Breast-Implant integrity, using the diagnosis at magnetic resonance imaging (MRI) as the “gold standard.” Fifty-five women with 109 Implants underwent a Breast examination either just before or shortly
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the diagnosis of Breast Implant rupture mri findings compared with findings at explantation
European Journal of Radiology, 2005Co-Authors: Lisbet Rosenkrantz Hölmich, Ilse Vejborg, Carsten Conrad, Susanne Sletting, Joseph K. MclaughlinAbstract:Study objective: The aim of this study was to evaluate the accuracy of Magnetic Resonance Imaging (MRI) as performed according to a strict study protocol in diagnosing rupture of silicone Breast Implants. Material and methods: The study population consisted of 64 women with 118 Implants, who had participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent Implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture (intracapsular or extracapsular), possible rupture or intact Implant was then obtained. Strict predetermined rupture criteria were applied as described in this report and findings at surgery were abstracted in a standardised manner and results compared. Results: At MRI, 66 Implants were diagnosed as ruptured, nine as possibly ruptured and 43 as intact. Among the ruptured Implants, 27 were categorized as extracapsular. At surgery, on average 297 days after the MRI, 65 of the 66 rupture diagnoses were confirmed, as were 20 of the cases with extracapsular silicone. Eight of the nine possibly ruptured Implants were in fact ruptured at surgery. Thirty-four of the 43 intact Implants were described as intact at surgery. When categorising possible ruptures as ruptures, there were one false positive and nine false negative rupture diagnoses at MRI yielding an accuracy of 92%, a sensitivity of 89%, and a specificity of 97%. Correspondingly, the predictive value of a positive MRI examination was 99% and the predictive value of a negative MRI examination was 79%. Conclusions: We conclude that MRI is highly accurate for identification of silicone Breast Implant rupture, with a high sensitivity and specificity when evaluation of images are based on presence of well-defined rupture criteria.
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Untreated silicone Breast Implant rupture.
Plastic and reconstructive surgery, 2004Co-Authors: Lisbet Rosenkrantz Hölmich, Ilse Vejborg, Carsten Conrad, Susanne Sletting, Mimi Høier-madsen, Jon P. Fryzek, Joseph K. Mclaughlin, Kim Kjøller, Allan Wiik, Søren FriisAbstract:Implant rupture is a well-known complication of Breast Implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone Breast Implant rupture. The aim of the present study was to evaluate whether untreate
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incidence of silicone Breast Implant rupture
Archives of Surgery, 2003Co-Authors: Lisbet Rosenkrantz Hölmich, Ilse Vejborg, Carsten Conrad, Susanne Sletting, Jon P. Fryzek, Joseph K. Mclaughlin, Kim Kjøller, Søren Friis, Jorgen H OlsenAbstract:Hypothesis The incidence of silicone Breast Implant rupture varies with Implantation time and type of Implant. Objective To measure the incidence of Implant rupture by repeated magnetic resonance imaging (MRI) among women with silicone Breast Implants. Design, Setting, and Participants In 1999, 271 women who had received Breast Implants at least 3 years before, and who were randomly chosen from a larger cohort of women with cosmetic Breast Implants, underwent a baseline MRI. A second MRI was performed in 2001; 317 silicone Implants (in 186 women) that were intact at the baseline MRI (n = 280) or were intact at baseline but removed before the second MRI (n = 37) were included in the rupture incidence analyses. Main Outcome Measures Implants were diagnosed with definite or possible rupture. Crude and Implant age–adjusted incidence rates were calculated, and Implant survival was estimated based on the observed rupture rates. Results We found 33 definite ruptures (10%) and 23 possible ruptures (7%) during the 2-year period. The overall rupture incidence rate for definite ruptures was 5.3 ruptures/100 Implants per year (95% confidence interval, 4.0-7.0). The rupture rate increased significantly with increasing Implant age. Double-lumen Implants were associated with substantially lower rupture risk than single-lumen Implants. For modern Implants intact 3 years after Implantation, we estimated rupture-free survival of 98% at 5 years and 83% to 85% at 10 years. Conclusions The risk of Implant rupture increases with Implant age. A minimum of 15% of modern Implants can be expected to rupture between the third and tenth year after Implantation.
Miles H Prince - One of the best experts on this subject based on the ideXlab platform.
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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
Plastic and Reconstructive Surgery, 2019Co-Authors: Mark R. Magnusson, Elisabeth Elder, Miles H Prince, Rodney Cooter, Ken Beath, Michelle Locke, Anand K DevaAbstract: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
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Breast Implant associated anaplastic large cell lymphoma long term follow up of 60 patients
Journal of Clinical Oncology, 2014Co-Authors: Roberto N Miranda, Mitual Amin, Tariq N Aladily, Miles H Prince, Rashmi Kanagalshamanna, Daphne De Jong, Luis Fayad, Nisreen Haideri, Govind Bhagat, Glen S BrooksAbstract:Purpose Breast Implant‐associated anaplastic large-cell lymphoma (ALCL) is a recently described clinicopathologic entity that usually presents as an effusion-associated fibrous capsule surrounding an Implant. Less frequently, it presents as a mass. The natural history of this disease and long-term outcomes are unknown.
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Breast Implant associated anaplastic large cell lymphoma a systematic review of the literature and mini meta analysis
Current Hematologic Malignancy Reports, 2013Co-Authors: Philip A Thompson, Miles H PrinceAbstract:Breast Implant-associated ALCL (BIA-ALCL) is a rare, but likely under-reported entity, which most commonly presents with an effusion developing between the Breast Implant and the host fibrous capsule that surrounds it. It has been described in association with Breast Implants used for post-cancer reconstructive surgery and when Implanted for purely cosmetic reasons. Two different presentations are seen; presentation with an effusion alone +/- co-existing capsular contracture, without an associated mass, and presentation with a mass lesion +/- an effusion. These two presentations are associated with very different outcomes, with women presenting with effusion alone having an excellent long-term survival, even in the absence of specific therapy other than Implant removal. In these women, no further therapy other than Implant removal is likely necessary. In contrast, women presenting with a mass lesion have a higher rate of relapse and may require more aggressive therapy.
Mona Ry Bishara - One of the best experts on this subject based on the ideXlab platform.
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Primary anaplastic large cell lymphoma of the Breast arising in reconstruction mammoplasty capsule of saline filled Breast Implant after radical mastectomy for Breast cancer: an unusual case presentation
Diagnostic Pathology, 2009Co-Authors: Mona Ry Bishara, Cathy Ross, Monalisa SurAbstract:Background Primary non-Hodgkin lymphoma (NHL) of the Breast represents 0.04–0.5% of malignant lesions of the Breast and accounts for 1.7–2.2% of extra-nodal NHL. Most primary cases are of B-cell phenotype and only rare cases are of T-cell phenotype. Anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma typically seen in children and young adults with the Breast being one of the least common locations. There are a total of eleven cases of primary ALCL of the Breast described in the literature. Eight of these cases occurred in proximity to Breast Implants, four in relation to silicone Breast Implant and three in relation to saline filled Breast Implant with three out of the eight Implant related cases having previous history of Breast cancer treated surgically. Adjuvant postoperative chemotherapy is given in only one case. Secondary hematological malignancies after Breast cancer chemotherapy have been reported in literature. However in contrast to acute myeloid leukemia (AML), the association between lymphoma and administration of chemotherapy has never been clearly demonstrated. Case Presentation In this report we present a case of primary ALCL of the Breast arising in reconstruction mamoplasty capsule of saline filled Breast Implant after radical mastectomy for infiltrating ductal carcinoma followed by postoperative chemotherapy twelve years ago. Conclusion Primary ALK negative ALCL arising at the site of saline filled Breast Implant is rare. It is still unclear whether chemotherapy and Breast Implantation increases risk of secondary hematological malignancies significantly. However, it is important to be aware of these complications and need for careful pathologic examination of tissue removed for Implant related complications to make the correct diagnosis for further patient management and treatment. It is important to be aware of this entity at this site as it can be easily misdiagnosed on histologic grounds and to exclude sarcomatoid carcinoma, malignant melanoma and pleomorphic sarcoma by an appropriate panel of immunostains to arrive at the correct diagnosis of ALCL.
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primary anaplastic large cell lymphoma of the Breast arising in reconstruction mammoplasty capsule of saline filled Breast Implant after radical mastectomy for Breast cancer an unusual case presentation
Diagnostic Pathology, 2009Co-Authors: Mona Ry Bishara, Catherine Ross, Monalisa SurAbstract:Background Primary non-Hodgkin lymphoma (NHL) of the Breast represents 0.04–0.5% of malignant lesions of the Breast and accounts for 1.7–2.2% of extra-nodal NHL. Most primary cases are of B-cell phenotype and only rare cases are of T-cell phenotype. Anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma typically seen in children and young adults with the Breast being one of the least common locations. There are a total of eleven cases of primary ALCL of the Breast described in the literature. Eight of these cases occurred in proximity to Breast Implants, four in relation to silicone Breast Implant and three in relation to saline filled Breast Implant with three out of the eight Implant related cases having previous history of Breast cancer treated surgically. Adjuvant postoperative chemotherapy is given in only one case. Secondary hematological malignancies after Breast cancer chemotherapy have been reported in literature. However in contrast to acute myeloid leukemia (AML), the association between lymphoma and administration of chemotherapy has never been clearly demonstrated.
Joseph K. Mclaughlin - One of the best experts on this subject based on the ideXlab platform.
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the diagnosis of silicone Breast Implant rupture clinical findings compared with findings at magnetic resonance imaging
Annals of Plastic Surgery, 2005Co-Authors: Lisbet Rosenkrantz Hölmich, Jon P. Fryzek, Kim Kjøller, Vibeke Breiting, Anna Jorgensen, Christen Krag, Joseph K. MclaughlinAbstract:Abstract:The objective was to evaluate the usefulness of clinical examination in the evaluation of Breast-Implant integrity, using the diagnosis at magnetic resonance imaging (MRI) as the “gold standard.” Fifty-five women with 109 Implants underwent a Breast examination either just before or shortly
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the diagnosis of Breast Implant rupture mri findings compared with findings at explantation
European Journal of Radiology, 2005Co-Authors: Lisbet Rosenkrantz Hölmich, Ilse Vejborg, Carsten Conrad, Susanne Sletting, Joseph K. MclaughlinAbstract:Study objective: The aim of this study was to evaluate the accuracy of Magnetic Resonance Imaging (MRI) as performed according to a strict study protocol in diagnosing rupture of silicone Breast Implants. Material and methods: The study population consisted of 64 women with 118 Implants, who had participated in either one or two study MRI examinations, aiming at determining the prevalence and incidence of silent Implant rupture, respectively, and who subsequently underwent explantation. Implant rupture status was determined by four independent readers and a consensus diagnosis of either rupture (intracapsular or extracapsular), possible rupture or intact Implant was then obtained. Strict predetermined rupture criteria were applied as described in this report and findings at surgery were abstracted in a standardised manner and results compared. Results: At MRI, 66 Implants were diagnosed as ruptured, nine as possibly ruptured and 43 as intact. Among the ruptured Implants, 27 were categorized as extracapsular. At surgery, on average 297 days after the MRI, 65 of the 66 rupture diagnoses were confirmed, as were 20 of the cases with extracapsular silicone. Eight of the nine possibly ruptured Implants were in fact ruptured at surgery. Thirty-four of the 43 intact Implants were described as intact at surgery. When categorising possible ruptures as ruptures, there were one false positive and nine false negative rupture diagnoses at MRI yielding an accuracy of 92%, a sensitivity of 89%, and a specificity of 97%. Correspondingly, the predictive value of a positive MRI examination was 99% and the predictive value of a negative MRI examination was 79%. Conclusions: We conclude that MRI is highly accurate for identification of silicone Breast Implant rupture, with a high sensitivity and specificity when evaluation of images are based on presence of well-defined rupture criteria.
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Untreated silicone Breast Implant rupture.
Plastic and reconstructive surgery, 2004Co-Authors: Lisbet Rosenkrantz Hölmich, Ilse Vejborg, Carsten Conrad, Susanne Sletting, Mimi Høier-madsen, Jon P. Fryzek, Joseph K. Mclaughlin, Kim Kjøller, Allan Wiik, Søren FriisAbstract:Implant rupture is a well-known complication of Breast Implant surgery that can pass unnoticed by both patient and physician. To date, no prospective study has addressed the possible health implications of silicone Breast Implant rupture. The aim of the present study was to evaluate whether untreate
-
incidence of silicone Breast Implant rupture
Archives of Surgery, 2003Co-Authors: Lisbet Rosenkrantz Hölmich, Ilse Vejborg, Carsten Conrad, Susanne Sletting, Jon P. Fryzek, Joseph K. Mclaughlin, Kim Kjøller, Søren Friis, Jorgen H OlsenAbstract:Hypothesis The incidence of silicone Breast Implant rupture varies with Implantation time and type of Implant. Objective To measure the incidence of Implant rupture by repeated magnetic resonance imaging (MRI) among women with silicone Breast Implants. Design, Setting, and Participants In 1999, 271 women who had received Breast Implants at least 3 years before, and who were randomly chosen from a larger cohort of women with cosmetic Breast Implants, underwent a baseline MRI. A second MRI was performed in 2001; 317 silicone Implants (in 186 women) that were intact at the baseline MRI (n = 280) or were intact at baseline but removed before the second MRI (n = 37) were included in the rupture incidence analyses. Main Outcome Measures Implants were diagnosed with definite or possible rupture. Crude and Implant age–adjusted incidence rates were calculated, and Implant survival was estimated based on the observed rupture rates. Results We found 33 definite ruptures (10%) and 23 possible ruptures (7%) during the 2-year period. The overall rupture incidence rate for definite ruptures was 5.3 ruptures/100 Implants per year (95% confidence interval, 4.0-7.0). The rupture rate increased significantly with increasing Implant age. Double-lumen Implants were associated with substantially lower rupture risk than single-lumen Implants. For modern Implants intact 3 years after Implantation, we estimated rupture-free survival of 98% at 5 years and 83% to 85% at 10 years. Conclusions The risk of Implant rupture increases with Implant age. A minimum of 15% of modern Implants can be expected to rupture between the third and tenth year after Implantation.