title: Breast Implant Informed Consent Should Include the Risk of Anaplastic Large Cell Lymphoma.
abstract: Breast implant-associated anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma arising around breast implants. Public awareness has increased following a safety communication warning of the association of breast implant-associated ALCL by the U.S. Food and Drug Administration in 2011. Difficulty with determining an accurate assessment of risk, including diagnosis, or standardized treatment regimen has led surgeons to commonly omit preoperative discussion of this rare and frequently misunderstood cancer. Risk disclosure is a form of respect for patient autonomy, and informed consent has positive practical and moral consequences for the practice of plastic surgery. A model of breast implant-associated ALCL informed consent implementation and health care provider education are reviewed with 1-year process follow-up at a tertiary cancer center. Breast implant-associated ALCL should be included during preoperative counseling on the risks of breast implantation when obtaining informed consent. Pertinent aspects of decision-making include disease awareness, presenting symptoms, and resources for concerned patients. Education of health care professionals and provision of patient-focused materials ensures effectiveness of the informed consent process.
authors.affiliation: Houston, Texas.|From the Departments of Plastic Surgery and Hematopathology, The University of Texas M. D. Anderson Cancer Center.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Clemens
authors.affiliation: Houston, Texas.|From the Departments of Plastic Surgery and Hematopathology, The University of Texas M. D. Anderson Cancer Center.
authors.forename: Roberto N
authors.initials: RN
authors.lastname: Miranda
authors.affiliation: Houston, Texas.|From the Departments of Plastic Surgery and Hematopathology, The University of Texas M. D. Anderson Cancer Center.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Butler
mesh_terms: D019928:Breast Implantation / Q000009:adverse effects / Q000295:instrumentation*; D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007258:Informed Consent; D017728:Lymphoma, Large-Cell, Anaplastic / Q000209:etiology*; D018570:Risk Assessment; D012307:Risk Factors; D014342:Truth Disclosure