Breast Implant Associated
Breast implant associated-Anaplastic Large Cell Lymphoma (BIA-ALCL)
Breast implant associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare cancer that can be effectively treated if detected early.
Facts associated with BIA-ALC
- It is a cancer of lymphatic cells and a form of Non-Hodgkin’s Lymphoma
- It is not a breast cancer
- It occurs in association with breast implants and to date exclusively with exposure to textured implants (ie. no case has been reported with exposure to smooth implants alone)
- It occurs in women who have had implants for both cosmetic and reconstructive indications
- It takes an average of 7-10 years after implant insertion before it develops
- The common presentation is a fluid swelling around the breast implant and in the space between the implant and breast implant capsule.
- The diagnosis of the tumour is made by examination of the seroma fluid.
- Early stage disease is curable with surgery alone.
- Disease which has spread through the capsule, forming a mass or which has spread to local lymph glands carries a worse prognosis
How common is breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)?
BIA-ALCL is a very rare condition. Fewer than 10 patients each year are diagnosed with this form of lymphoma. It is estimated that 10 to 11 million women throughout the world have received breast implants. The vast majority of cases of the disease have occurred in patients who have received textured implants. The risk of developing BIA-ALCL ranges from one in about 1,000 to one in 30,000 for people with textured breast implants.
What are the risk factors?
The exact cause of BIA-ALCL is not known, but risks seem to increase for implants with textured surfaces. It does not seem to matter if the implants are filled with silicone or saline. Textured implants may cause more inflammation than smooth implants. Possible contributing factors include reactions to implant particles, long-term allergies, genetic factors, or reactions to bacteria that grow on the implant’s surface. There seems to be no difference in the risk of BIA-ALCL among women who receive implants for breast augmentation or for breast reconstructive surgery.
What are the symptoms of (BIA-ALCL)?
If you experience symptoms that concern you in the area of your breast implants, try to remember that non-cancer issues are a much more likely cause. It is recommended that women perform monthly self-examinations to check for lumps or other issues. All implant related symptoms should be evaluated by a specialist.
In cases of BIA-ALCL, symptoms like changes in the size or shape of the breasts appear well after the surgical sites are healed. One breast may appear larger than the other or look different in shape from the other (asymmetric). Usually, it takes at least two years after surgery for symptoms to emerge. However, the average length of time before symptoms appear is eight years.
Symptoms of BIA-ALCL may include:
- Swelling or fluid accumulation in the breast or around an implant
- Changes in the shape or size of the breast or breasts
Diagnosis and Tests
Women who have received breast implants should report any new changes in the size or appearance of their breasts to their doctor and schedule a physical examination. Routine mammograms or breast X-rays will not detect this type of lymphoma. If your doctor suspects you might have breast implant-associated lymphoma, he or she may schedule diagnostic procedures that might include one or more of the following:
- Ultrasound or magnetic resonance imaging: Diagnostic imaging tests are performed to detect any fluid accumulation or lumps in the breast or swelling of lymph nodes.
- Needle biopsy: If imaging tests show there is a mass or excess fluid, a fine needle biopsy will be performed. During the procedure, a small amount of fluid is withdrawn from the breast with a needle. The sample is then sent to a lab for further testing.
If diagnostic tests confirm the presence of BIA-ALCL, the patient will be referred to an oncologist (specialist in treating cancer). The oncologist will determine the stage of the disease and recommend a treatment plan. Treatment will depend on the type and stage of the disease, the general health of the patient, her age, and other factors.
Surgery: In most cases, surgical removal of the implant and the fibrous capsule around it (capsulectomy) is effective for treating the disease. Removal of some lymph nodes may also be necessary if they contain cancer cells.
Chemotherapy: In rare cases where the cancer is more advanced or aggressive, patients may need to undergo chemotherapy in addition to surgery
There is no way to prevent the disease, although early diagnosis and treatment can improve the outcome. Contact Dr Alzubaidy promptly, if you have breast implants and experience symptoms such as new swelling, a new lump, breast pain, or changes in appearance. Discuss any concerns you might have with him. If you are planning to have cosmetic or reconstructive breast surgery, Dr Alzubaidy will help you make an informed decision about what type of implants are right for you.