Objectives: BIA-ALCL is recognized as a distinct entity. In the French Lymphopath network, 128 suspected cases of BIA-ALCL have been identified in France (n=107) and Belgium (n=21) since 2010.
In situ BIA-ALCLs have an indolent clinical course and remain in complete remission mainly after implant removal. Infiltrative BIA-ALCLs have a more aggressive clinical course. Multiple implants and/or a past history of breast cancer could favor the occurrence of BIA-ALCL. New insights into the biology of BIA-ALCL might translate into more targeted and effective therapies.

Introduction: BIA-ALCL is recognized as a distinct entity. In the French Lymphopath network, 128 suspected cases of BIA-ALCL have been identified in France (n=107) and Belgium (n=21) since 2010. Diagnosis was validated within the Lymphopath network in 125

Materials / method: Overall, median age at diagnosis of BIA-ALCL was 58 years (24-82 years). Reasons for initial implantation were breast cancer reconstruction (n=54; 49%), cosmetic (n=45; 41%) or other (n=12; 10%). The median interval from first implantation to diagnosis of BIA-ALCL was 12.3 years (4-40 years). The median number of implants in the breast involved by BIA-ALCL was 2 (1-8), including at least one silicone implant in 95 (86%) patients, and at least one textured implant in all informative cases (n=102; Most often Allergan Biocell implants).

Results: At diagnosis of BIA-ALCL, 78/110 (71%) patients presented with periprosthetic effusion only, 20 (18%) had effusion and a breast mass, 6 (5.5%) had a breast mass only, and 6 (5.5%) had neither. At pathological examination of the capsule, T-stage was T1 (confined to effusion or a layer on luminal side of capsule) in 73/111 (66%) cases, T2-T3 (capsule infiltration) in 5 (4.5%) cases, T4 (lymphoma infiltrates beyond the capsule) in 32 (29%) cases, and unclassifiable in 1 case.
Moreover, 18/111 (16%) patients had at least one non-breast extranodal involvement. Among the 36 patients with capsule in

Conclusion: In situ BIA-ALCLs have an indolent clinical course and remain in complete remission mainly after implant removal. Infiltrative BIA-ALCLs have a more aggressive clinical course. Multiple implants and/or a past history of breast cancer could favor the occurrence of BIA-ALCL. New insights into the biology of BIA-ALCL might translate into more targeted and effective therapies.

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