Being diagnosed with breast implant cancer (BIA-ALCL) may cause you to feel anxiety, frustration and fear. However, it’s important to remember that each type of cancer is different, and some cancers have a better prognosis than others. When BIA-ALCL is detected early, most patients can expect a favorable outcome.
A subtype of non-Hodgkin’s lymphoma, ALCL is a rare disease only recently linked to breast implants. It is estimated that breast implant-associated ALCL affects about 230 Americans and 570 people worldwide.
Due to these small numbers, doctors have limited information about BIA-ALCL. In addition, breast implant-associated ALCL can present itself in similar ways to other diseases and cancers of the breast, making it even more difficult to diagnose.
To tell BIA-ALCL apart from other diseases or illnesses with similar symptoms, a doctor must first assess two things: your risk for the disease and your symptoms.
Breast Implants and Cancer Risk
In most cases, women receive a breast implant cancer diagnosis after noticing either a mass or a collection of fluid (known as “seroma”) in the scar tissue (or “capsule”) that forms around the implant over time. The bacteria that collect in this area can lay dormant for years. As a result, these symptoms may not appear for as many as eight to 10 years after implantation.
Experts are not yet certain whether a patient’s risk of developing BIA-ALCL depends on the type of implant fill, silicone gel or saline. However, the vast majority of BIA-ALCL cases have occurred in women with textured implants that stick to the scar tissue.
Specific products and manufacturers include:
- MemoryGel™ SILTEX silicone breast implants by Mentor (acquired by Johnson & Johnson)
- Natrelle® silicone breast implants by Allergan (acquired by Actavis)
- Opus™ silicone breast implants by Sientra
Whether used for breast reconstruction or augmentation, these and similar products create a small but increased risk of developing breast implant cancer, the FDA has now confirmed. If you are still unsure about your risk for BIA-ALCL, check for the following symptoms.
What Are the Symptoms of BIA-ALCL?
The signs and symptoms that lead to a breast implant cancer diagnosis vary from person to person, but most commonly appear in the breast itself. See a doctor promptly if you experience any changes in the way your breast looks or feels.
Possible changes and symptoms include:
- Pain or discomfort
In less common cases, BIA-ALCL symptoms can include fever, skin rash, a lump in the breast caused by the contraction in the capsule or a lump in the lymph node near the armpit.
It is normal to experience pain or swelling immediately after implant insertion. There is no need to worry about the possibility of BIA-ALCL unless these symptoms occur long after the incision has healed.
How Is Breast Implant Cancer Diagnosed?
During your visit, a physician will start by performing a physical exam. They will also review your medical history, current health habits. They will need to know what type of implants and surgery you received. They will then use one or more of the following tests to either detect or rule out BIA-ALCL.
- Needle biopsy: This is a procedure used to obtain cell samples for lab testing. To test for BIA-ALCL, doctors use a specific type of needle biopsy called fine-needle aspiration to take samples of seroma.
- Drainage of capsule fluid: Even when BIA-ALCL is present, the capsule often appears normal to the naked eye. Your doctor might also recommend sending the capsule for lab testing after draining seroma from the tissue.
- Imaging tests: These might include an ultrasound, PET-CT or CAT scan, MRI scan or mammography to pick up abnormalities in the seroma.
- Toxicity testing: There has been an increasing discussion around heavy metals and toxins within the implant leaking into surrounding breast tissue. Your doctor might perform a silicone toxicity test to check for the presence of these metals.
If your doctor confirms the presence of BIA-ALCL, they will refer you to a multidisciplinary care team for follow-up BIA-ALCL testing. Additional tests may include a bone marrow biopsy, for example, to determine whether the cancer has spread. Then you are ready to begin treatment.
Do You Need a Second Opinion?
Due to how challenging it is to detect BIA-ALCL, your doctor might not be able to confirm a breast implant cancer diagnosis even after performing the above tests. In this case, they will refer you to a specialist for a second opinion.
Experts tend to agree that it is important to get a second opinion no matter the outcome of your tests. They are especially important for rare and misunderstood diseases like BIA-ALCL, which often lead to inaccurate diagnoses or inappropriate treatment. A second opinion can bring emotional reassurance on this long, difficult journey and address the unique challenges you face.
Specialist input also allows for a timely response. The earlier BIA-ALCL is caught, the earlier you can begin treatment and the more effective that treatment will be.
Your Next Steps
If you or a loved one suspects you might have BIA-ALCL, there is hope for a full recovery. Most cases remain confined to the implant, so a favorable outcome is highly likely after receiving timely, appropriate treatment.
That said, the costs for treatment can add up, and they are costs you never budgeted for. Paying out of pocket for any breast implant-associated ALCL treatments would never have been necessary if breast implant manufacturers had not neglected to warn patients and doctors about the link between implants and cancer.
Our Breast Implant Cancer Advocates are on your side and here to help.