Methods: A systematic
review of the literature was conducted in PubMed (legacy), Embase (Embase.com),
and Scopus with four search strategies including key terms centered around
breast reconstruction and BIA-ALCL.
Results: A total of 571 articles were identified, of which
276 were included in the final review after duplicates were removed. After
review, no articles were determined to fit the inclusion criteria of
demonstrating data-driven evidence of BIA-ALCL risk reduction through surgical
measures, demonstrating a significant lack of data on risk reduction for
BIA-ALCL.
Conclusions: Risk management for BIA-ALCL is an evolving
area requiring additional investigation. Although removal of textured devices
in asymptomatic patients is not currently recommended by the Food and Drug
Administration, variability in estimates of risk has led many patients to
electively replace these implants in an effort to decrease their risk of
developing BIA-ALCL. To date, however, there is no evidence supporting the
concept that replacing textured implants with smooth implants reduces risk for
this disease. This information should be used to aid in the informed consent
process for patients presenting to discuss management of textured breast
implants.
