BRCA1/2 impact on the development of implant-associated lymphoma in women with breast cancer and textured implants
Menée aux Pays-Bas auprès de 520 patientes atteintes d'un cancer du sein et ayant bénéficié d'une reconstruction par implants texturés, cette étude analyse le rôle des mutations BRCA dans le risque de lymphome anaplasique à grandes cellules associé aux implants mammaires
Breast Implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a type of T-cell lymphoma arising near textured breast implants. In a Dutch population, a higher prevalence of BRCA1/2 was found in BIA-ALCL. We analyzed the risk of BIA-ALCL occurrence related to BRCA in a large population of women with implants followed after breast cancer (BC) mastectomy. We compared the prevalence of BRCA1/2 between women from a large cohort of BC patients who did and did not develop BIA-ALCL after reconstruction with textured implants. Hazard ratios (HRs) of developing BIA-ALCL were estimated using Cox regression. We also conducted a case-control study. Of 520 patients with BC tested for BRCA, age-adjusted rate of developing BIA-ALCL for women with BRCA was 16 times the rate of BIA-ALCL among women without BRCA (HR 95% C.I. 3.6, 76.1, p < 0.0003). Carrying bilateral implants (HR 3.9, 95% C.I. 0.4, 32.7), chemotherapy (HR 0.95, 95% C.I. 0.2, 4.2), radiation therapy (HR 0.37, 95% C.I. 0.04, 3.1) were not associated with BIA-ALCL. We also conducted a case-control study with 13 BIA-ALCL cases matched 1:3 with 39 controls. We used a complete enumeration of Bernoulli probability to rule out a non-association of BRCA with BIA-ALCL (p=0.0002). In this study, We define the role of BRCA1/2 mutations as a risk factor in developing BIA-ALCL in patients with BC. These results will help women undergoing breast reconstruction or with textured implants in place.
Blood Advances , article en libre accès, 2025