Breast Implant–Associated Malignancies: Current Recommendations for Workup and Management

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Name the 3 major subtypes of breast implant-associated (BIA) malignancies. 2. Recognize the most common presenting symptoms of BIA malignancies. 3. Identify appropriate treatment options for each BIA malignancy, including chemotherapy, radiation, and surgery. 4. Answer patient questions about recurrence and reconstruction after a diagnosis of BIA malignancy. SUMMARY: Although rare, breast implants have been associated with several malignancies, categorized into 3 major subtypes: BIA anaplastic large-cell lymphoma, B-cell lymphoma, and squamous cell carcinoma. BIA anaplastic large-cell lymphoma is the most common subtype, with more than 1700 cases reported to date. BIA squamous cell carcinoma is the most aggressive subtype. The most common presenting symptom is late seroma. Patients typically report pain and swelling. Workup should begin with an ultrasound or mammography, and any fluid collections should be aspirated and evaluated in conjunction with pathology. The authors provide an algorithm for surgical excision and adjuvant treatment based on disease stage and subtype.