Is there an association between the use of textured breast implants with anaplastic large cell lymphoma?

Introduction: Anaplastic Large Cell Lymphoma (ALCL) is a rare type of non-Hodgkin's lymphoma and some reports have indicated a possible association between its occurrence and the implantation of breast implants, especially the textured ones. However, so far, little is known about the disease process and its relationship with breast implants. Objective: Thus, the aim of this study was to identify whether there is an association between the use of breast implants and the development of ALCL. Method: A systematic literature review was performed on the databases: Medline via PubMed, Cochrane Library, Embase and Virtual Health Library (VHL) in February 2019 using the terms "Breast Implantation" and "anaplastic large-cell lymphomas." Results: A total of 797 studies were identified, of which 12 were selected and included in the present study: 2 case-control studies, 5 retrospective database records, 1 prospective cohort and 4 systematic case report reviews. Case-control studies have shown increse the chance of ALCL in breast implant patients. In the reported cases of ALCL, most were relate to textured surface implants; however, data may be skewed as this is the best-selling type of prosthesis worldwide. Most of the procedures were performed for aesthetic reasons, followed by breast reconstruction after breast cancer and mastectomy. In these cases, it is not known whether reconstruction is a risk or aggravating factor for the development of ALCL. The data came from studies conducted in the United States of America - USA, Netherlands, Sweden, United Kingdom and Italy. Conclusion: To date, data indicate an association between breast implant and the development of ALCL; however, there is no way to establish a causal relationship.