International research collaborations on Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIAborstimplantaat gerelateerde-ALCLAnaplastisch Grootcellig Lymfoom) initiated by a scientific meeting organised by RIVMRijksinstituut voor Volksgezondheid en Milieu in Amsterdam on November the 19th, 2018.
On November 19th 2018, the Dutch National Institute for Public Health and the Environment (RIVM), supported by the Dutch Ministry of Healthcare, Welfare and Sport (VWSMinisterie van Volksgezondheid, Welzijn en Sport ) and the Dutch Health and Youth Care Inspectorate (IGJInspectie Gezondheidszorg en Jeugd), brought together in Amsterdam (the Netherlands) an international multidisciplinary group of regulators, public health authorities, medical specialists, epidemiologists, experts on implant registries, and breast implant manufacturers to discuss the problem of a rare form of lymphoma seen in women with breast implants.
In the past few years, an increased risk for a rare and usually well treatable form of lymphoma in women with breast implants has become apparent. This form of lymphoma is called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). BIA-ALCL has been described in an increasing number of case reports followed by more in depth research publications, by various research groups from the United States and Australia, as well as several other countries. In a study reported in JAMAJournal of the American Medical Association Oncology in January 2018, the Dutch BIA-ALCL Consortium found that women with breast implants are more than 400 times more likely to get this rare form of lymphoma than women without implants, although the absolute risk remains small.
During the meeting, open questions regarding worldwide variation in incidence of BIA-ALCL, possible associations with specific implants, host susceptibility factors (i.e. age, medical history, genetics), local infections, pathogenesis and treatment were discussed. It was concluded that international collaboration is key to learn more about this rare type of lymphoma in women with breast implants. Research goals were formulated, as well as initiatives to harmonise national breast implant registries and look more closely into pathology databases for the occurrence of BIA-ALCL. The International Collaboration of Breast Registry Activities (ICOBRA™) was proposed as intermediary to align the breast implant registries worldwide. Finally, the participants brainstormed on possible funding strategies such as a public-private partnership model maintaining full scientific independence.
International Working Groups in specific research areas will be established to prepare research proposals that will be discussed and further elaborated in a follow-up meeting in 2019.
This document contains a summary of the meeting.