Dr. Gayle on Current Treatment Options in Breast Implant-Associated ALCL

Lloyd B. Gayle, MD, director of Plastic Surgery Resident Education and associate professor of clinical surgery at Weill Cornell Medical College, director of plastic surgery, vice-chairman of surgery, Maimonides Medical Center, attending surgeon in plastics at the Hospital for Special Surgery, and an associate attending surgeon in the Division of Plastic Surgery at NewYork-Presbyterian Hospital, discusses current treatment options for patients who develop breast implant—associated anaplastic large cell lymphoma (ALCL).

Breast implant—associated ALCL is a relatively new disease, says Gayle. However, it is understood that with early diagnosis, specifically in patients with stage I/II disease where there is no spread beyond the breast, the capsule, and the surrounding soft tissue, the best treatment is total capsulectomy. Total capsulectomy is defined as an unblocked resection, whereby the implant, the surrounding capsule, and any surrounding mass within the soft tissue are removed.

Radiation therapy and chemotherapy are supplemental treatments that do not have a primary role in patients with relatively early disease, says Gayle.

Although surgery is the primary intervention for patients with breast implant—associated ALCL, treatment is interdisciplinary. Patients are seen by plastic surgeons and surgical oncologists, as well as radiation oncologists and medical oncologists to determine whether additional treatment is indicated, concludes Gayle.