Is reimplant after breast implant-associated anaplastic large cell lymphoma a safe procedure? Yes, no, or may be?

Breast implant-associated (BIA) anaplastic large cell lymphoma (ALCL) is a rare clinical-pathologic entity recently recognized in the 2016 WHO classification of lymphoid neoplasms. Being a very rare lymphoma sub-type, it is difficult to be certain about the absolute risk of developing this disease and the issues about pathogenesis and etiology are still controversial and matter of debate. Current treatment strategies indicate that the capsulectomy and removal of breast implants are required. An excellent prognosis is reached after surgical removal. Thanks to the excellent prognosis, an increasing number of women who underwent breast implant for aesthetical reasons express the desire of a new reimplant, if safe. Here we present the case of a 48 years old woman diagnosed with a BIA-ALCL developed 8 years after breast implants for aesthetic reasons, in absence of any breast disease, with no evidence of disease 6 months after implant removal. She worried about her physical aspect after bilateral removal of breast implants and asked how safe a breast reimplant would be. After a careful analysis of pros and cons we concluded that smooth implants could be re-inserted after at least 1 year of follow-up, once the absence of any recurrence was confirmed. Given the relevance of the question proposed by our patient, we believe that more information on safety of breast reimplant is urgently needed.