Breast Implant-Associated Anaplastic Large-Cell Lymphoma in Brazil: What Are We Missing?

Plast Reconstr Surg. 2022 Nov 1;150(5):970e-978e. doi: 10.1097/PRS.0000000000009652. Epub 2022 Aug 22.


Background: Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) has been diagnosed in more than 1000 patients in more than 30 countries, although only a few cases have been reported in Latin America and the Caribbean to date. As the second-largest global market for breast implants with a predominance of textured-surface implants, Brazil is a major global market for cosmetic augmentations, making it unlikely that cases of BIA-ALCL are actually scarce.

Methods: A local and voluntary registry of patients with BIA-ALCL was initiated in 2018. All patients diagnosed with BIA-ALCL were confirmed by the World Health Organization criteria. Implant characteristics, disease symptoms, treatment, and oncologic outcomes were assessed.

Results: Fourteen cases of BIA-ALCL in a Brazilian population were identified in the Paraná state. Disease-specific diagnostic tests were omitted before surgical intervention in 50 percent of patients. With additional cases from a literature review, the treatment and outcomes of 29 cases of BIA-ALCL in Brazil were assessed.

Conclusions: Compared with other populations, these initial observations suggest that awareness of the disease by the local breast surgery community remains low and that a number of cases may remain undiagnosed. Lack of preoperative diagnostic testing compromises disease treatment, oncologic outcomes, and both short- and long-term surveillance.

Publication types

  • Review

MeSH terms

  • Brazil / epidemiology
  • Breast Implantation* / adverse effects
  • Breast Implants* / adverse effects
  • Breast Neoplasms* / epidemiology
  • Breast Neoplasms* / etiology
  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Lymphoma, Large-Cell, Anaplastic* / diagnosis
  • Lymphoma, Large-Cell, Anaplastic* / epidemiology
  • Lymphoma, Large-Cell, Anaplastic* / etiology
  • Mastectomy