Original articles

Part 1: Breast implant-associated anaplastic large-cell lymphoma: Systematic review of the current level of evidence on pathogenesis

C L Kulenkampff, W G Kleintjes


Background. Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a newly defined clinical entity. However, much of the research around this topic is based on prognostic studies with low levels of evidence.

Objective. To conduct a literature review on the pathogenesis of BIA-ALCL. Methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Based on the grading system for levels of evidence for prognostic studies suggested by Burns et al., each article was graded between 3 and 4.

Results. After articles were removed based on exclusion criteria, 55 remained for review. These included level 5 expert-opinion and bench-research articles (n=39), level 4 case series reports (n=4) and level 3 case control studies and systematic reviews of case control articles (n=12). No level 1 or 2 research articles were found in our search.

Conclusion. Our study describes potential BIA-ALCL risk factors, and provides the level of evidence for the interpretation of recommendations for clinical practice and further study.

Authors' affiliations

C L Kulenkampff, Department of General Surgery, Cecilia Makiwane Hospital, East London, South Africa

W G Kleintjes, Western Cape Provincial Tertiary Adult Burn Unit, Division of Surgery, Tygerberg Hospital and Stellenbosch University, Cape Town, South Africa

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South African Journal of Plastic & Reconstructive Aesthetic Surgery & Burns 2020;3(1):14. DOI:10.7196/SAJPRASB.2020.v3i1.36

Article History

Date submitted: 2020-05-19
Date published: 2020-05-19

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