Evidence map›Paper›PMID 33222158›Full record

GuidelineBritish journal of haematology2021

UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma on behalf of the Medicines and Healthcare products Regulatory Agency Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group.

Philip Turton, Dima El-Sharkawi, Iain Lyburn, Bhupinder Sharma, Preethika Mahalingam, Suzanne D Turner, Fiona MacNeill, Laura Johnson, Stephen Hamilton, Cathy Burton and 1 more

Open access · hybridAbstract readPractice Guideline
In one paragraph

Guideline in British journal of haematology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Current Challenges in Breast Implantation.Medicina (Kaunas, Lithuania) · 2021
    Review
  12. Review
  13. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 2 countries.

Philip TurtonSt James's Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Dima El-SharkawiRoyal Marsden NHS Foundation Trust, London, UK.
Iain LyburnCobalt Medical Charity, Cheltenham, UK.
Bhupinder SharmaRoyal Marsden NHS Foundation Trust, London, UK.
Preethika MahalingamRoyal Marsden NHS Foundation Trust, London, UK.
Suzanne D TurnerDivision of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK.ORCID 0000-0002-8439-4507
Fiona MacNeillRoyal Marsden NHS Foundation Trust, London, UK.
Laura JohnsonBarts Health NHS Trust, London, UK.
Stephen HamiltonRoyal Free Hospital, London, UK.
Cathy BurtonSt James's Hospital, The Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Nigel MercerBristol Plastic Surgery, Bristol, UK.
Royal Marsden NHS Foundation Trust · GBLeeds Teaching Hospitals NHS Trust · GBAt Bristol · GBBarts Health NHS Trust · GBGloucestershire Hospitals NHS Foundation Trust · GBMRC Laboratory of Molecular Biology · GBThe Royal Free Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T-cell non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body. Diagnosis is usually made by cytological, immunohistochemical and immunophenotypic evaluation of the aspirated peri-implant fluid: pleomorphic lymphocytes are characteristically anaplastic lymphoma kinase (ALK)-negative and strongly positive for CD30. BIA-ALCL is indolent in most patients but can progress rapidly. Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative. Late diagnosis may require more radical surgery and systemic therapies and although these are usually successful, poor outcomes and deaths have been reported. By adopting a structured approach, as suggested in these guidelines, early diagnosis and successful treatment will minimise the need for systemic treatments, reduce morbidity and the risk of poor outcomes.

Indexed as

Breast ImplantsDisease ManagementFemaleHumansLymphoma, Large-Cell, AnaplasticPlastic Surgery ProceduresSurgery, PlasticUnited KingdomBIA-ALCLbreast implantslymphomareconstructive breast surgerytreatment guidelines

Identifiers

PMID33222158
PMCPMC7894347
OpenAlexW3108120276

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.