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ALCL and Lymphoma with Breast Implants

Jandali Plastic Surgery

Breast implants are frequently used for breast augmentation and breast reconstruction and millions of women currently have them. However, recent studies have revealed a link between breast implants and a rare type of lymphoma known as Anaplastic Large Cell Lymphoma (ALCL). This has raised concerns among women who have undergone breast augmentation or reconstruction, and it is important for them to understand the risks and take necessary precautions.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare form of cancer that can develop in some women with breast implants. It is a type of non-Hodgkin’s lymphoma. It is a cancer of the immune cells and usually occurs in the fluid and tissue surrounding the implant. BIA-ALCL can occur in women who have breast implants filled with either silicone or saline. The incidence of BIA-ALCL is low, but it is important for women with breast implants to be aware of this condition and its potential risks.

Causes of Breast Implant Associated Lymphoma

The exact cause of BIA-ALCL is unknown, but research suggests that it may be related to a reaction to the textured surface of some breast implants. Textured breast implants are designed to adhere to the surrounding tissue and prevent the implant from moving or rotating within the breast. However, some studies have found that the textured surface may cause an inflammatory response in the body, which can lead to the development of BIA-ALCL.

Is BIA-ALCL common? 

BIA-ALCL is a very rare condition. According to the FDA, there have been approximately 1,000 reported cases of BIA-ALCL worldwide, out of an estimated 10-11 million women who have received breast implants. However, with certain implants, like the recalled Allergan textured gummy bear implants (410 implants), the risk can be as high as 1 in 300 patients.  

Symptoms of Breast Implant Associated Lymphoma

The symptoms of BIA-ALCL can vary, but they often involve changes in the breast and surrounding tissue. Some common symptoms of BIA-ALCL in women that have implants include:

  • Swelling or seroma (fluid) in the breast
  • Pain in the breast
  • Lump or mass in the breast
  • Skin rash or redness around the breast
  • Enlarged lymph nodes in the armpit

It is important to note that these symptoms can also be caused by other conditions, such as infection, injury, or breast cancer. It is important to see a board certified breast surgeon or Dr. Jandali as soon as possible if you have breast implants and have any of these symptoms.

Diagnosis of Breast Implant Associated Lymphoma

If you are experiencing symptoms of BIA-ALCL, Dr. Jandali may order tests to help diagnose the condition. Some common tests used to diagnose BIA-ALCL include:

  • Ultrasound: This test can look at the breast tissue and also look for fluid around the implant.
  • MRI: This test uses a magnetic field to create detailed images of the breast tissue and also look for fluid around the implant.
  • Biopsy: This involves removing a small sample of fluid or tissue from around the breast implant and performing special tests and stains and examining it under a microscope to look for cancer cells.

If a diagnosis of BIA-ALCL is confirmed, your breast surgeon or oncologist may order additional tests to determine the stage of the cancer and the best treatment options.

Treatment of Breast Implant Associated Lymphoma

The treatment for BIA-ALCL depends on the stage of the cancer and the individual patient’s needs. Some common treatments for BIA-ALCL include:

  • Surgery: In almost all cases, the breast implant and entire surrounding capsule (scar tissue around the implant) needs to be removed to treat the cancer. In most cases, ALCL is curable if caught early and treated promptly with surgery.
  • Radiation therapy: This involves using high-energy radiation beams to kill cancer cells.
  • Chemotherapy: This involves using drugs to kill cancer cells.

In some cases, a combination of these treatments may be used. It is important to work with Dr. Jandali, a breast surgeon, and an oncologist to determine the best treatment plan for your individual needs.

En Bloc Capsulectomy in Connecticut for Treatment of ALCL

For patients diagnosed with breast implant-associated ALCL, the most important treatment is surgery to remove the breast implant and the entire capsule or scar tissue around it. This is performed with what is called an “en bloc capsulectomy” which means that the entire capsule is removed with the implant and the fluid completely intact and as one specimen.  The idea is that no cancerous cells or fluid can escape from inside the capsule if it’s removed intact.  This is then sent to the pathologist that can confirm that the margins are negative and the ALCL is completely cleared. Your oncologist will monitor to ensure that the cancer has not spread past the breast. Once someone is diagnosed with ALCL in one breast, if there are implants in both breasts, they are usually both removed. This is performed since there is a very small percentage of patients who will have it in both breasts.  

Prevention of Breast Implant Associated Lymphoma

While the risk of developing BIA-ALCL is low, there are steps that women with breast implants can take to reduce their risk of developing this condition. Some tips for preventing BIA-ALCL include:

  • Choose a board-certified plastic surgeon who is experienced in breast implant surgery.
  • Only use smooth breast implants for your cosmetic augmentation or breast reconstruction.  Smooth implants have a purported zero risk of developing ALCL.
  • Remove your textured implants if they have been recalled and switch them to smooth implants or your own tissue (DIEP flaps).
  • Be aware of the signs and symptoms of BIA-ALCL and seek medical attention if you experience any of these symptoms.
  • Follow up regularly with your surgeon and get routine breast exams.

Frequently Asked Questions

What is Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)?

BIA-ALCL is a rare type of non-Hodgkin’s lymphoma that develops in the scar tissue and fluid near a breast implant. It is not breast cancer.

What are the symptoms of BIA-ALCL?

Symptoms of BIA-ALCL may include persistent swelling or pain around the breast implant, a lump in the breast or armpit, hardening of the breast, fluid collection around the breast implant, changes in the size, shape, or position of the breast implant, and skin rashes on the breasts.

How is BIA-ALCL treated?

The primary treatment for BIA-ALCL usually involves surgery to remove the breast implant and the surrounding scar tissue. In some cases, chemotherapy and/or radiation therapy may be needed.

Taking Charge of Your Breast Health

It is important to keep in mind that not all breast implant-related health issues are related to ALCL. In some cases, women may experience other complications such as capsular contracture, implant rupture, or infection. These complications can be addressed through revision surgery and should be monitored by Dr. Jandali

At Jandali Plastic Surgery, we are committed to providing the highest standard of care to our patients. We regularly monitor our patients for any potential complications and take necessary steps to address any issues that may arise.

While the risk of developing ALCL with breast implants is low, it is important to be aware of the symptoms and seek medical attention if you experience any changes in your breast area. We encourage you to schedule a consultation with Dr. Jandali if you have any concerns.

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