How do you treat BIA-ALCL?

Updated: Sep 22, 2020

Written by Board Certified Plastic Surgeon Nima Naghshineh, MD, FACS on July 8th, 2020.

If you have a diagnosis of BIA-ALCL your treatment will be coordinated amongst a team of specialists. The team may include a plastic surgeon, medical oncologist, surgical oncologist, hematologist, radiation oncologist, radiologist and pathologist.

Here’s what they do:

  • Medical oncologist: coordinates treatment of cancers with medicines such as chemotherapy

  • Plastic surgeon: will perform the implant removal, En bloc total capsulectomy, and potential removal of any masses.

  • Surgical oncologist: may perform additional lymph node surgery or tissue removal

  • Hematologist: a medical doctor specializing in treatment of blood disorders

  • Radiation oncologist: should radiation treatment be necessary this is the doctor who will be performing it

  • Radiologist: imaging such as an MRI, ultrasound, mammogram, etc. will be performed by this doctor

  • Pathologist: Will look at your tissues and fluid under a microscope to help make a diagnosis

Staging (or extent of disease) will be determined based on your imaging results as well as results from your surgery which will include En bloc total capsulectomy, removal of the implant, and removal of any masses or lymph nodes. You would also typically remove the implant on the other side along with performing in En bloc total capsulectomy. (see En Bloc Capsulectomy article)

Based off of your staging and what could be performed during surgery and what the pathologist sees you may or may not need additional treatment which could include chemotherapy and/or radiation.

Once your treatments are completed, you will need to be monitored through exams as well as imaging every 3 to 6 months for the next two years and then as indicated.

Case of a 32-year-old woman was diagnosed with BIA-ALCL 6 years after her initial cosmetic surgery.

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