Risk of Anaplastic Large-Cell Lymphoma (ALCL) in Cases of Late Seroma Formation After Breast Implant Insertion

Kun Hwang, MD, PhD; Hun Kim, PhD; Hyung Mook Kim, MD; Joo Ho Kim, MD


ePlasty. 2021;21:e4 

In This Article


In a PubMed search, 415 articles were found using the terms "breast implant AND seroma" (n = 232), "breast implant AND effusion" (n = 42), and "anaplastic large cell lymphoma AND breast" (n = 141). Among the 415 titles, 348 were excluded while 67 abstracts met our inclusion criteria ("breast implant" or "seroma" or anaplastic large cell lymphoma" appeared in the title). Studies that did not include an evaluation of the incidence of late seroma or ALCL after breast implantation were excluded. Using these exclusion criteria, 50 abstracts were excluded and 17 full-text articles that evaluated the incidence of late seroma or ALCL in patients who underwent breast implantation were reviewed. Of these 17 articles, 10 were excluded because they were uncontrolled studies (7 articles), did not have sufficient content (2 articles), or were not an original article (1 article), while 20 articles were added from the reference list of the articles identified in the searches. Ultimately, 27 articles were analyzed (Figure 1).[4–30]

Figure 1.

PRISMA flowchart, showing the selection process of the articles included in this study. ALCL indicates anaplastic large-cell lymphoma.

No restrictions on language and publication form were imposed. However, the full-text articles were mostly in English. All articles were read by 2 independent reviewers who extracted data from the articles.

To determine the relationship of seroma with ALCL, the data were summarized and the OR for ALCL between patients who did and did not have seroma was calculated. Weighted mean differences and 95% confidence intervals (CIs) were also calculated.

A statistical analysis was performed with Review Manager (The Nordic Cochrane Centre). If the exact number of the cases was not specified in the article, it was calculated from the reported percentage of incidence.