Breast implant-associated anaplastic large cell lymphoma What we know, what we do not know

Background The unexplained pathogenesis and unclear individual risk profile of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) result in persistent uncertainty of patients and physicians. Objective The incidence, pathogenesis and level of evidence of the current state of knowledge are presented. Material and methods This article presents an assessment and discussion of the current literature. Results The pathogenesis of the tumor is so far largely not understood. Most cases are reported in association with textured implants. Multiple potential mechanisms are discussed, whereby a multifactorial genesis is assumed to lead to a malignant transformation of T-cells. A chronic inflammatory reaction with subsequent immune stimulation seems to play a key role. The level of evidence is at best moderate. A specific risk estimation based on current data is only possible with considerable limitations and must be interpreted with caution.