Breast implant surgery is a common procedure. Naturally, patients who are undergoing the surgery will have a litany of questions and concerns that they wish to address beforehand. One of the more common questions we have received in the recent months is a link between breast implants and breast cancer.
Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a very rare form of T-cell lymphoma that may develop around breast implants. This is a type of non-Hodgkin’s lymphoma that attacks the immune system’s cells.
“You need to know that this is not a breast cancer,” stresses Dr. Kevin Smith, a board certified plastic surgeon at Charlotte Plastic Surgery. “Breast implant-associated ALCL is a very rare occurrence, and interestingly it appears that surgically treating the patients with this tumor by removing the scar tissue around the implant and replacing a new implant appears to cure the disease.”
Although incidence of the linked condition is uncommon, the prognosis for BIA-ALCL is typically excellent. In fact, in all known cases with no delayed diagnosis, 100 percent of patients were cured. Watch in full as Dr. Smith dives into the reality of the link made between breast implants and breast cancer.
“Of concern for most patients is: Are they at risk? And for most patients, they will not be at risk,” says Dr. Stephan Finical, another board certified plastic surgeon at Charlotte Plastic Surgery.
Since a quick diagnosis leads to a quick and complete recovery, it is important to recognize the warning signs that may indicate there is a problem. The most common symptom patients experience is continual swelling of the breasts. This occurs when fluid collects in the area surrounding the implant. Some patients might also develop thick masses near the implant or experience a tightened or tender sensation. This is known as “capsular contracture,” and it may cause pain or discomfort.
Symptoms may take as many as 14 years to develop, but might start appearing as soon as three years after surgery. In most cases, they occur about eight years later. Also in almost all cases, BIA-ALCL is localized to the capsule surrounding the breast implant, and not within the tissue of the breasts themselves.
Once those symptoms are apparent, it is important to seek medical attention immediately. This is the key to a complete and successful cure. A needle aspiration of the fluid is first done and sent to a lab for testing. Diagnosed patients undergo surgery to have both implants and the surrounding capsules removed. Chemotherapy may be advised, as well.
“This is a very treatable type of lymphoma,” says Dr. Finical. “Most of our patients have smooth-surface implants—this is not a worry. But if you have concerns, you can certainly go to the American Society of Plastic Surgeons website, and you can go to The American Society for Aesthetic Plastic Surgery website,” for more information.
To date, there are 12 worldwide deaths linked to the condition. None of these patients received the necessary surgical excision or targeted therapy. Most of them also received a delayed diagnosis and subsequent treatment—at least one to two years after the development of their symptoms.
What is responsible for this connection between breast implants and cancer? Data indicates that BIA-ALCL tends to occur in patients who receive textured breast implants instead of those with smooth surfaces, which is what the surgeons at Charlotte Plastic Surgery typically use.
“There have been no reports of solely smooth-surface patients having this particular type, this very rare type of cancer,” adds Dr.Finical.
It should be noted that it is not specifically clear whether it is the texture that is responsible for the development of the disease. That said, textured implants represent a small percentage of the breast implant surgeries performed in America—approximately 70,000 of about 550,000 total, according to The American Society for Aesthetic Plastic Surgery. Also, the material contained within the implant—whether it is silicone gel or saline—does not appear to increase the risk of developing BIA-ALCL.
If you are considering the procedure but are concerned about the link between breast cancer and implants, keep these statistics in mind: Of the approximately 1.5 billion breast implant surgeries performed all over the world and the 550,000 done in the United States, there are just a few hundred reported incidences of BIA-ALCL. The lifetime risk of developing the disease is one in 30,000.
“There are millions of patients in the world who have breast implants,” says Dr. Smith. “Since 1997, we’ve seen 28 cases in the United States, and possibly 150 or 160 identified internationally.”
Patients who already have textured breast implants may wonder if it is necessary to have them removed. If you are not experiencing any symptoms, you do not need to consider this as a preventative measure. If you do feel pain, discomfort, or think something seems “off” or different, though, it is important to get in touch with your plastic surgeon as soon as possible.