Breast Implants and Cancer
In 1997, a woman with breast implants was diagnosed with a type of cancer that doctors had never seen before. Since then, there has been a worldwide effort to understand the specific disease and its connection with breast implants.
The specific disease is now recognized as breast implant-associated anaplastic large cell lymphoma or BIA-ALCL for short. If diagnosed early, BIA-ALCL is highly treatable. Therefore, it is especially important to understand and recognize the symptoms. The U.S. Food and Drug Administration (FDA) advises women who currently have, have had or are considering getting breast implants to be aware of the risks associated with them.
After a breast implant is placed in the body, scar tissue forms around the foreign object. This scar tissue is known as the capsule. Between the capsule and the implant, lymphatic fluid can build up. This is known as a “seroma.” Most often, BIA-ALCL is first discovered in the seroma or the capsule. Over time, it can spread to lymph nodes and other distant parts of the body.
The Basics of BIA-ALCL
Cancer is classified based on where it originates in the body. Lymphoma begins in the immune system. Therefore, even though BIA-ALCL appears in the breast, it is not a type of breast cancer (carcinoma). The immune system protects the body from disease and infection. Lymphomas prevent the immune system from working properly.
BIA-ALCL is referred to as a T-cell lymphoma because T-cells are the first part of the immune system it affects. T-cells are a type of white blood cell. White blood cells circulate throughout the body, finding and destroying bacteria, viruses and other foreign invaders.
When a woman develops BIA-ALCL, it means that a T-cell has become abnormal. This cell divides again and again, multiplying rapidly. Like all cancers, this unregulated growth of cells can spread, form tumors and affect other parts of the body. If untreated, it can lead to serious illness and death.
What Types of Breast Implants are Associated With ALCL?
Even though breast implant cancer is uncommon, women should be aware of the risk of developing it. Currently, there is no type or model of breast implant that can be ruled out as either “safe” or “unsafe.” Women with both saline and silicone-filled implants have developed BIA-ALCL. Additionally, the reason for the implants, whether reconstructive or cosmetic, seems of no significance.
The most important risk factor to be aware of is the surface-type of the implant. Breast implants are either smooth or textured. Textured breast implants have rougher surfaces designed to better “stick” to the tissue inside of the body. This prevents them from moving, which can happen to smooth implants.
Unfortunately, current theories suggest that the very design of textured breast implants contributes to the development of BIA-ALCL. Textured breast implants have been involved in a vast majority of reported cases of BIA-ALCL.
How Rare Is BIA-ALCL? What Are the Risks?
All cases of ALCL are rare. Approximately one in 500,000 women are diagnosed with ALCL in the United States each year. BIA-ALCL is even less common, with an estimated 3 in 100 million women diagnosed in the United States each year.
The FDA recommends that women with breast implants continue to receive regular cancer screenings and breast wellness exams, such as mammograms. It is also crucial for women to follow their doctor’s instructions for monitoring their breast implants.
Women who notice changes in their breast are advised to get in touch with their doctor immediately. More tests will be necessary to confirm a diagnosis because routine cancer screenings are usually not enough to make an accurate confirmation of BIA-ALCL.
BIA-ALCL Symptoms and Signs
In roughly half of the confirmed cases of breast implant-associated ALCL, symptoms have developed eight to 10 years after breast implant surgery. It may develop earlier than that, and there are cases of women reporting symptoms as much as 28 years after the operation.
The most common symptoms are pain and swelling in the breast near the implant, which begins more than one year after surgery. This is important because having pain and swelling is normal immediately following surgery.
Common symptoms associated with BIA-ALCL include:
- Breast enlargement
- Lumps in the breast or armpit
- Breast asymmetry or changes in appearance
Other symptoms may include:
- Skin rash
- Hardening of the breast
- Weight loss
It is also important to pay attention to your overall health. Remember, BIA-ALCL is a form of lymphoma, which affects the immune system. Getting sick more easily or an increased sensitivity to chemicals (perfume, household cleaners, exhaust fumes and so on) could be early warning signs.
The key is to catch BIA-ALCL before it spreads.
Getting Treatment and Getting Help
Even though it is rare, getting any symptoms checked out is always the safest bet. As with any cancer, diagnosing BIA-ALCL early offers the best chance for a favorable outcome. Typically, both the implant and the capsule are removed from the body in a procedure known as explant surgery. If the cancer is contained within the capsule, the outcome is usually positive.
If the cancer has spread, however, explant surgery alone may not be enough—and the odds of cancer returning increase. Advanced cases may require chemotherapy or radiotherapy, both of which can have painful and sometimes long-lasting side effects.
There is nothing good about being diagnosed with cancer, but there are many people working to help you right now.
You may not know them yet, but they include doctors, scientists, advocates and families all around the world who have helped turn the tide against cancer. It is an awful disease that has taken far too many lives, but each year, more and more people are being saved by new treatments. There is still much more to learn about BIA-ALCL. However, once it is diagnosed, doctors are armed with treatment plans that have saved many other women with the same disease.
As you walk this path, know that you are not alone.