How should I manage a confirmed case of BIA-ALCL?
- Definitive treatment for most patients is removal of the implants and total capsulectomy, which includes complete resection of any mass associated with the capsule.
- The implant, capsule, and effusion should all be sent to pathology for evaluation.
- Suspicious lymph nodes should also be excised.
- Complete surgical resection may be sufficient treatment for the majority of patients.
How should BIA-ALCL patients be reconstructed?
- Ideal type and timing of reconstruction remains controversial.
- Autologous reconstructions that do not require a breast implant are advisable.
- Replacement of textured implants is not advised in a patient that has already demonstrated a propensity for malignant degeneration.
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