In Reply We thank Altundag and Fleury for their interest in our article.¹ The pathogenesis of this rare disease entity is still under investigation. However, all cases with detailed implant history have been linked to textured implants.

Altundag commented on the lack of detailed information about the clinicopathological characteristics of the patients’ breast cancers as well as the chemotherapy and radiation therapy they received. This was a systematic review of the literature, and therefore, we were limited to previously published data. The vast majority of articles did not list any information about the clinicopathological details of the primary breast cancer and treatment. If information was reported, it was very basic (ie, stated that the patient underwent chemotherapy). We agree with Altundag that some breast cancer subtypes, such as triple-negative or human epidermal growth factor receptor 2–positive breast cancer, are more immunogenic. However, to our knowledge, there are no widespread data to suggest that these patients are more likely to develop breast implant–associated anaplastic large cell lymphoma (BIA-ALCL). Additionally, a significant number of patients with BIA-ALCL had cosmetic surgery without any history of breast cancer. This accounted for 46% of patients in our review article.¹

作为回复，我们感谢 Altundag 和 Fleury 对我们文章的兴趣。¹这种罕见病实体的发病机制仍在调查中。然而，所有具有详细植入历史的病例都与纹理植入物有关。

Altundag 评论说，缺乏有关患者乳腺癌的临床病理学特征以及他们接受的化学疗法和放射疗法的详细信息。这是对文献的系统评价，因此，我们仅限于以前发表的数据。绝大多数文章没有列出任何有关原发性乳腺癌的临床病理学细节和治疗的信息。如果报告了信息，它是非常基本的（即，说明患者接受了化疗）。我们同意 Altundag 的观点，即某些乳腺癌亚型，例如三阴性或人表皮生长因子受体 2 阳性乳腺癌，具有更高的免疫原性。然而，据我们所知，没有广泛的数据表明这些患者更有可能患上乳房植入物相关的间变性大细胞淋巴瘤 (BIA-ALCL)。此外，相当多的 BIA-ALCL 患者进行了整容手术，但没有任何乳腺癌病史。在我们的评论文章中，这占了 46% 的患者。¹