Updated: May 16
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, capsulectomy (partial or total), 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 likely be total capsulectomy (often inaccurately referred to as En Bloc Total Capsulectomy to imply removal in one piece), 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 possibly performing a 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.