TO THE EDITOR:

Women with a germline mutation in the BRCA1 or BRCA2 genes have high cumulative risks of developing breast cancer before the age of 80 years (ie, ∼72% and 69%, respectively). To reduce risk, an increasing proportion of BRCA1/2 mutation carriers opt for preventive mastectomy and reconstruction with breast implants. However, breast implants are associated with a strongly increased relative risk (odds ratio = 400) of anaplastic large-cell lymphoma (BIA-ALCL), with a low absolute risk of 1/7000 at age 75 years.2-4  Host susceptibility factors for BIA-ALCL are largely unknown. As we observed several women with BRCA1/2 mutations, implants and BIA-ALCL, we examined whether BRCA1/2 mutation carriership increases the risk of BIA-ALCL in women with implants.

In December 2018, we identified 49 confirmed cases of BIA-ALCL (median age, 55 years; range, 29-75) via the Dutch nationwide Pathology Database;...

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