Answer Happy

Table 1 Characteristics of the cohort of women with breast implants (N= 3546). Characteristic n (%) Median age at surgery, y (range) 48 (18-89) Type of reconstruction Unilateral 1069 (30.1%) Bilateral 2477 (69.9%) Type of textured implant Silicone 1797 (50.6%) Saline 1749 (49.4%) Surface of textured implant -Biocell 3429 (96.7%) -Siltex 82 (2.3%) - True texture 24 (0.7%) -unknown 11 (0.3%) Total implants inserted 6023 Reconstruction after 5821 (96.7%) mastectomy Cosmetic procedure for 202 (3.3%) contralateral augmentation Baseline breast cancer histology Lobular 685 (19.3%), 117 in situ Ductal 2543 (71.7%), 593 in situ Other 60 (1.7%) Unknown 258 2%) Breast cancer management - other than surgery Chemotherapy only 1025 (28.9%) Radiotherapy only 287 (8.1%) Chemotherapy + radiotherapy 714 (20.1%) None 1520 (42.9%) Table 2 Characteristics of the BIA-ALCL cases and history of the textured devices. Characteristic N(%) Bilateral/unilateral 8/10 (80%)/2/10 (20%) reconstruction Silicone/saline filling 5/10 (50%)/5/10 (50%) Histology of breast ca Lobular/ductal 3/10 (30%)/ 7/10 (70%) In situ/Infiltrating 5/10 (50%)/ 5/10 (50%) Median time from tissue 5.3 months (range 3.4 - 12 expander to permanent months) implant Other implant exchanges 3/10 (30%) (all replaced with textured devices) Chemotherapy for breast ca 5/10 (50%) Radiotherapy for breast Ca 1/10 (10%) Treatment of BIA-ALCL Implant removal and 10/10 (100%) capsulectomy Chemotherapy and radiation 1/10 (10%) esthetic revision, capsular contracture or asymmetry. In this case, since the implants were replaced with textured im plants, the risk of exposure was assumed to be equivalent to the risk of people not undergoing revisionary surgery. After a median exposure of 11.7 years (range, 7.4-15.8 years), 10 women developed BIA-ALC(1:355 women). All 10 had macro-textured implants and the median age at di- agnosis was 60 years (range, 53-73 years). Seven women