Synchronous Breast Implant–associated Anaplastic Large Cell Lymphoma and Invasive Carcinoma: Genomic Profiling and Management Implications

Rita A. Mukhtar, MD; Michael Holland, MD; David A. Sieber, MD; Kwun Wah Wen, MD, PhD; Hope S. Rugo, MD; Marshall E. Kadin, MD; Gregory R. Bean, MD, PhD

doi:10.1097/GOX.0000000000002188

Plastic and Reconstructive Surgery, Global Open (Apr 2019)

Synchronous Breast Implant–associated Anaplastic Large Cell Lymphoma and Invasive Carcinoma: Genomic Profiling and Management Implications

Rita A. Mukhtar, MD,
Michael Holland, MD,
David A. Sieber, MD,
Kwun Wah Wen, MD, PhD,
Hope S. Rugo, MD,
Marshall E. Kadin, MD,
Gregory R. Bean, MD, PhD

Affiliations

Rita A. Mukhtar, MD: From the *Department of Surgery, University of California San Francisco, San Francisco, Calif.
Michael Holland, MD: From the *Department of Surgery, University of California San Francisco, San Francisco, Calif.
David A. Sieber, MD: †Sieber Plastic Surgery, San Francisco, Calif.
Kwun Wah Wen, MD, PhD: ‡Department of Pathology, University of California San Francisco, San Francisco, Calif.
Hope S. Rugo, MD: §Helen Diller Family Comprehensive Cancer Center, University of California San Francisco; San Francisco, Calif.
Marshall E. Kadin, MD: ¶Department of Dermatology and Skin Surgery, Boston University School of Medicine; Boston, Mass.
Gregory R. Bean, MD, PhD: **Department of Pathology, Stanford University School of Medicine, Stanford, Calif.

DOI: https://doi.org/10.1097/GOX.0000000000002188
Journal volume & issue: Vol. 7, no. 4
p. e2188

Abstract

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SUMMARY:. A 59-year-old woman with a history of cosmetic implants developed ipsilateral synchronous breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) and invasive ductal carcinoma in the left breast. Each tumor was subjected to next-generation sequencing, and separate analyses revealed mutually exclusive aberrations: an activating STAT3 mutation in the lymphoma and a PIK3CA in-frame deletion in the carcinoma. The patient was treated with removal of implants, capsulectomy, partial mastectomy, sentinel node biopsy, radiotherapy, and endocrine therapy with no evidence of recurrence for 1 year. This case illustrates the importance of obtaining thorough evaluation for concomitant malignancies in the breast at the time of diagnosis of BIA-ALCL. Herein, we review the current recommendations for evaluation and management of BIA-ALCL.

Published in Plastic and Reconstructive Surgery, Global Open

ISSN: 2169-7574 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://www.prsgo.com

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