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Risk Of Lymphomas Of The Breast Following Breast Reconstruction
Dylan K. Kim, AB1, Lauren S. Lowe, BS
1, Christine H. Rohde, MD MPH
1, David P. Horowitz, MD
2, Alfred I. Neugut, MD PhD
3, Connor J. Kinslow, MD
2.
1Division of Plastic and Reconstructive Surgery, Columbia University Irving Medical Center, New York, NY, USA,
2Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY, USA,
3Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA.
Purpose: The US Food and Drug Administration (FDA) recently issued a safety communication for reports of various lymphomas of the breast that developed in association with breast implants and were distinct from BIA-ALCL. We investigate the risk of non-BIA-ALCL breast lymphomas in a population of women who have undergone implant reconstruction after mastectomy for breast cancer.
Methods: We identified women who underwent mastectomy with implant-based reconstruction for tumors within the breast using the SEER 17 database (2000-2020). Multiple primary-standardized incidence ratios (SIR) were used to compare the number of observed versus expected cases of ALCL and non-ALCL breast lymphomas diagnosed in the study population.
Results: The final cohort comprised 61,043 women who were followed for 478,864 person-years. There were 7 observed cases of breast ALCL (SIR 43.7, 95%CI 17.6-90.1) and 8 cases of other lymphomas of the breast (SIR 2.94, 95%CI 1.27-5.80). In comparison, the risk of developing lymphomas outside of the breast was not elevated (SIR 0.98, 95%CI 0.86-1.11). Of the 8 cases of other breast lymphomas, 5 were diffuse large B-cell, 2 were small lymphocytic, and 1 was peripheral T-cell, not otherwise specified.
Conclusion: To our knowledge, this is the first report of an increased risk of non-ALCL breast lymphomas after breast implantation. The absolute excess risk is similar to that of breast ALCL. These findings may inform future guidance from regulatory agencies.
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