Table 2.

Diagnosis and management of BIA-ALCL in transgender patients

	Patient 1	Patient 2	Patient 3	Patient 4
Imaging	CT, Breast MRI, PET	Ultrasound, Mammogram, PET	Breast MRI, PET	Ultrasound, Mammogram, PET
Surgery	Unilateral mastectomy (implant previously removed) with resection of pectoral muscle, and axillary node dissection	Bilateral implant removal with capsulectomy of affected side	Unilateral implant removal with capsulectomy, mass resection with part of pectoral muscle	Bilateral implant removal with capsulectomy of affected side and sentinel lymph node biopsy, excision of active lymph node
Implant status	Intact	Intact (previous rupture and exchange)	Ruptured	Intact
Margin status	Positive	Negative	Negative	Positive
Axillary status	Negative	Unchecked	Unchecked	Positive
Radiation	No radiation therapy	No radiation therapy	No radiation therapy	Total 36Gy in 18 fractions to R axilla and 30Gy to R breast
Chemotherapy	4 cycles of CHOP	No chemotherapy	6 cycles of CHOP	6 cycles of CHOP

BIA-ALCL: breast implant-associated anaplastic large cell lymphoma; CT: computer tomography; MRI: magnetic resonance imaging; PET: positron emission-tomography; CHOP: cyclophosphamide, doxorubicin, vincristine, prednisone