The truth about breast implant-related cancer risk

Breast implants.
BAI-ALCL is a rare cancer associated with breast implants. .

In March 2017, the Food and Drug Administration (FDA) issued a press release about a rare cancer called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which is associated with breast implants women receive after surgery cosmetic or reconstructive surgery.

In May 2017, the New York Times also picked up the topic, highlighting the struggles of a few women who developed BIA-ALCL. The majority of women had received a textured-surface breast implant during their breast procedure. This does not mean the breast cancer comes back – BIA-ALCL is actually a lymphoma, a cancer that affects the lymph nodes. 

Though BIA-ALCL can become a serious disease, there are three things we want women in North Texas to know:

  1. BIA-ALCL is rare. One in 30,000 women with textured-surface breast implants may develop it. The FDA has reported 359 cases of BIA-ALCL in the United States as of February 1, 2017, and nine women have died from the disease.
  2. Breast implants are safe. In fact, they’re among the most-studied devices in medicine. BIA-ALCL appears to be associated with textured-surface breast implants only, which account for a small number of implants.
  3. Getting breast implants is a personal choice. If you choose to do it, we’ll make sure you are well-informed of the benefits, risks, and available options.

Though BIA-ALCL is rare, it’s important that women familiarize themselves with the symptoms, how we diagnose and treat the disease, and the health follow-up guidelines we recommend if you choose to get breast implants after breast cancer surgery.

What BIA-ALCL symptoms should you look for?

The most common symptom of BIA-ALCL is excessive fluid buildup around the breast implant, which can cause pain, swelling, or lumps in the breast or armpit.

Symptoms usually occur between three and 14 years after implant placement. It is important to recognize the symptoms and see your plastic surgeon should they occur. If you are not experiencing any problems with your implants, there is no reason to be alarmed or have them removed. When BIA-ALCL does occur, it almost always can be cured.

It’s important to note that breast implant-associated ALCL seems to be related to textured-surface breast implants. The FDA reports that 28 of the 359 women who developed BIA-ALCL had smooth-surfaced implants. However, these women likely had textured-surface implants or textured-surface tissue expanders prior to their smooth-walled implants, which may have contributed to the inflammation.

Smooth-surface implants are more commonly used for cosmetic breast surgery. Textured surface implants are more commonly used during reconstructive procedures but may be used for cosmetic purposes as well. The American Society for Aesthetic Plastic Surgery Inc. (ASAPS) estimates that in the United States about 550,000 breast implants are placed each year. Of these, fewer than 13 percent are textured-surface breast implants.

This doesn’t mean that textured-surface implants are unsafe. The vast majority of women who have these implants will never develop health issues because of them. 

How is BIA-ALCL diagnosed and treated?

Researchers think that if the tissue around the implant and the capsule become inflamed, fluid builds up, damages the cells, and can cause cancer to develop in the fluid. If the disease progresses, it enters the capsule, a natural covering that the body builds around any foreign object, such as a breast implant, to protect the surrounding tissue. And if it progresses from there, it can invade other tissues, including the lymph nodes. This is why recognizing the symptoms is critical to timely diagnosis and treatment when it does occur.

We ask that women see us annually for a breast wellness check after implant placement. A patient’s well-woman exam with their gynecologist should also include a breast exam.

The fluid is the first thing we check in a patient with a new onset fluid collection around their breast implant. We’ll draw a sample of the fluid and send it to our lab to screen for CD30, a specific marker that indicates lymphoma. It’s not terribly uncommon for fluid to accumulate around breast implants and if it does, that does not mean you in fact have developed the disease.

Breast implant-associated ALCL can be cured by removing the breast implant and its capsule. If the cancer has spread beyond the lymph nodes, you may need to undergo chemotherapy. After three years, 93 percent of BIA-ALCL patients are disease-free when the condition is detected and treated early, according to ASAPS data. That’s an excellent prognosis.

You have options after breast cancer surgery

Undergoing breast reconstruction after breast cancer is a personal decision. Some women choose implants. Some undergo breast reconstruction from their own body tissue. And some women forgo reconstruction of any kind.

Our team would never push you into a decision after breast cancer. Our role is to present you with your options, recommend which you may be the best candidate for based on your unique condition, and provide education to help you make your choice.

To date, none of our patients have developed this condition, though we have helped in the care of several patients over the years who have developed it. By continually educating ourselves and our patients, hopefully we can help more women feel comfortable about their options regarding breast implant surgery.

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