Breast implants and a rare type of cancer are starting to populate our newsfeeds. Here at Mode Plastic Surgery, we wanted to help break through the speculation and keep our community in the know. We sat down with Dr Aggarwal and talked through the big questions surrounding Breast Implant-Associated Anaplastic Large Cell Lymphoma ALCL (or BIA-ALCL). If you have any further questions please don’t hesitate to contact us by emailing firstname.lastname@example.org or via our contact page.
Q: What is the rare form of cancer that is being linked to breast implants? Can implants really cause cancer?
A: Breast implants have been in the media recently due to a possible association with rare cancer called Breast Implant-Associated Anaplastic Large Cell Lymphoma. Only textured breast implants appear to be implicated, with smooth implants currently having no association with BIA-ALCL.
Q: What is breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)?
A: Simply put; Breast implant-associated ALCL is a rare type of cancer. It usually presents as a swelling of one breast due to an accumulation of fluid called delayed seroma. In rare cases it Breast implant-associated ALCL can take the form of a lump in the breast or armpit.
These symptoms occur on average 7.5 years after the insertion of implants. However, it can occur much sooner than this, as early as less than a year and late as 27 years after the operation as we have found in Australian and New Zealand records.
In the majority of cases of breast implant-associated ALCL, the patient can be cured by the removal of the implants and the capsule surrounding the implant. There are now over 700 cases reported and documented worldwide. While the disease has been very treatable in many there have been 33 worldwide recorded deaths, three of which were in Australia.
Q: What is the risk of lymphoma with breast implants?
A: If you would like a numerical answer the literature on the subject suggests a wide variety from 1 in 3,000 to 1 in 80,000 risks of developing lymphoma from breast implants.
A recent study conducted in Australia in 2017 (Wilkinson et al PRS 2017) documented the risk per each type of implant, they found;
- Biocell or Macro Textured implants (Allergan, Inamed, McGhan) have 1 in 3,817. We have never used these implants at Mode Plastic Surgery.
- Polyurethane implants (Silimed) have 1 in 60,631. We have never used these implants at Mode Plastic Surgery.
- Siltex or microtextured implants (Mentor) have a 1 in 60,631. We use the Mentor range of implants here at Mode Plastic Surgery as these carry the lowest risk of ALCL of all the textured implants.
Before you read this data and panic, when put into perspective the risk of breast cancer is one in eight and you could argue that the risk of breast cancer in women with strong family history, previous breast cancer, is higher than this, and those with high-risk genetic mutations can have a risk of up to 80% of developing breast cancer.
This means in simpler terms this disease remains extremely rare, and the vast majority of women with breast implants in place (regardless of which type they have in) will never develop this disease.
Q: How can breast implants cause lymphoma/ BIA-ALCL?
A: At this stage, there is an investigation underway as new research is ongoing. Thus far there is a suggestion that it is likely that there is a multitude of factors causing the disease such as genes and genetic type, as mentioned previously using the textured specified higher risk implants, time in which a person has had their implants and finally, there is support for an ‘infective theory’. This theory describes a concept of minor contamination of the implant at the time the implant is inserted.
Q: Which implants have been recalled in Australia?
A: Allergan has been forced to suspend and recall their Allergan Biocell implants that were still ‘on the shelf’ and not yet implanted into patients yet.
The Australian Therapeutic Goods Administration (TGA) in July 2019 put on notice all textured breast implants and expanders, indicating they are reviewing all of their use in the Australian market. What this means is that there is a potential for a suspension of some or all of these devices.
It is important to note that this was simply a warning in response to BIA-ALCL, and the implant manufacturers were asked to respond to indicate to the TGA why their products should not be suspended. As of August 2019, there has been no proposed regulatory action made to suspend any other implants other than Allergan, in Australia.
Additionally please note that there has been no ban or suspension placed on any implants other than Allergan’s around the world.
Q: How is breast implant-associated ALCL diagnosed?
A: If you develop a late swelling of the breast following breast implant you should inform us (or a doctor) immediately.
Dr Aggarwal will refer you for an ultrasound and at the same time, a fluid sample will be collected which will be sent off for a special marker of the disease (CD30).
You will not be required to undergo special imaging unless the marker returns positive from the ultrasound-guided aspiration.
To get more information about BIA-ALCL visit