Patient Perceptions of Textured Implants and Breast Implant-Associated Anaplastic Large Cell Lymphoma
Ilana G. Margulies, MS1, Kasey L. Wood, BS1, Yasmina Zoghbi, MD1, Andrew Y. Ashikari, MD2, C. Andrew Salzberg, MD1.
1Icahn School of Medicine at Mount Sinai, New York, NY, USA, 2Ashikari Breast Center, Yonkers, NY, USA.
Introduction: Recent efforts have intensified to uncover the prevalence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and investigate its association with textured breast implants. While this has garnered much attention both in the media as well as in the literature, little has been reported regarding patient perceptions of BIA-ALCL. Furthermore, limited research exists regarding patient knowledge of their implant type, which has contributed to the inability to accurately evaluate the role of textured implants in this disease process. Thus, the present study aims to quantitatively and qualitatively explore patient perceptions of textured implants and BIA-ALCL through a telephone-survey.
Methods: A retrospective review was conducted to identify all patients who received textured breast implants from 2011 to 2017 in a single surgeon’s practice. A telephone-survey and educational initiative was developed through an iterative process with the goal of assessing patient knowledge about characteristics of their implants and their perceptions of BIA-ALCL. Following administration of survey questions, patients were educated on BIA-ALCL disease process, symptoms, risk, and prognosis.
Results: Seventy-seven patients were identified as having received textured implants for breast reconstruction between 2011 to 2017. Thirty-three patients responded yielding a 44% response rate. Average age at the time of surgery and survey was 47.32 (10.33) years old and 52.21 (10.70) years old, respectively. Twenty-seven (81.82%) patients were Caucasian, 1 (3.03%) was Hispanic, and 6 (13.95%) had an unknown race/ethnicity. Twenty-six (60.47%) patients underwent oncologic mastectomy. Five patients previously had removal of textured implants, with one due to concerns over BIA-ALCL. While twenty-nine patients (87.88%) correctly identified their implants as silicone, only 8 (28.57%) patients with textured implants correctly identified their implant surface type. Twenty (60.61%) patients had previously heard about BIA-ALCL, with 6 (19%) patients able to identify at least one symptom of BIA-ALCL. Seven (21.21%) patients expressed concern that they were at increased risk for BIA-ALCL possibly due to previous cancer history. When asked about the prognosis of BIA-ALCL on a scale of 1 to 5 (1 as great a prognosis, 5 as very bad prognosis) respondents averaged 3.78 (1.02).
Conclusion: The present study highlights the need to improve patient awareness of their implant surface-type and increase education regarding current knowledge of the risk and prognosis of BIA-ALCL. Future multi-center studies to assess patient perceptions of BIA-ALCL are needed in order to optimize educational interventions as the literature grows on this important issue.
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