that "There was no preference for saline or silicone fill or for cosmetic or reconstructive indications." Where implant history was known, the patient had received at least one textured-surface device. In 2016, the World Health Organization (WHO) officially recognized BIA-ALCL. As of April 2022, the FDA has received 1,130 global medical device reports (MDRs) of BIA-ALCL, including 59 deaths. Since ALCL was thought to be diagnosed in only 1 woman in half a million, 60 women was a much higher number than would be expected. The researchers pointed out that BIA-ALCL could be fatal. If women with implants present with delayed swelling or fluid collection, cytologic studies and a test for the marker CD30 are suggested. The American Society of Plastic Surgery (ASPS) states, "CD30 is the main diagnostic test that must be performed on the seroma fluid as routine pathology or H&E staining can frequently miss the diagnosis." Diagnosis and treatment of breast implant-associated ALCL now follows standardized guidelines established by the National Comprehensive Cancer Network. The current lifetime risk of BIA-ALCL in the U.S. is unknown, but estimates have ranged between one in 70,000 and one in 500,000 women with breast implants, according to the MD Anderson Cancer Center. Countries with breast implant registries have the best data on the risks of BIA-ALCL. For example, as of October 2020, the Therapeutic Goods Administration of Australia and New Zealand reported a "1:3,345 risk with Allergan Biocell and a 1:86,029 risk with Mentor Siltex." AIn the U.S, estimates of the risk of BIA-ALCL in textured implants ranges from 1.79 per 1,000 (1 woman with BIA-ALCL per 559 implants) to 2.82 per 1,000 (1 woman per 355 implants)[2]. As of April 2022, the FDA reported 1,130 medical device reports (MDRs) of BIA-ALCL. Of those MDRs, 59 of the women died . FDA states that 798 of the 1,130 MDRs for BIA-ALCL involved textured breast implants, 37 MDRs involved smooth-surfaced implants, and 295 MDRs did not specify whether the implants were textured or smooth. In some cases, the women who developed BIA-ALCL after smooth breast implants had textured expanders prior to their implants. Most patients had BIA-ALCL affect only one breast with only 8 patients diagnosed with bilateral BIA-ALCL. The most common reported symptom of BIA-ALCL according to the FDA was seroma, followed by breast swelling and pain, capsular contracture, and peri-implant mass or lump. Furthermore, 84 percent of the reported implants