What Is Breast Implant Cancer?
Breast-implant cancer, or breast implant-associated large cell lymphoma (BIA-ALCL), is a specific form of non-Hodgkin’s lymphoma. It is not the same as the much more common breast cancer for which people may sometimes confuse it. A lymphoma-like ALCL occurs in a person’s immune system, also known as the lymphatic system.
The lymphatic system is the body’s internal defense network against disease and virus. It includes the body’s lymph nodes, spleen, thymus gland and bone marrow. Usually discovered eight to 10 years after a successful breast implantation procedure, BIA-ALCL tends to form in the area of the implant known as the “scar tissue capsule.”
If the cancer has progressed beyond the capsule, it can use the body’s system of lymph nodes to spread to other parts of the body. BIA-ALCL has a markedly higher incidence rate among women with textured implants as opposed to women with smooth-surface implants.
Does Fill Matter?
What Types of Breast Implants Are Associated with BIA-ALCL?
The surface textures of a woman’s breast implants are correlated with the incidence rate of breast implant-associated ALCL. As of now, data suggest that breast-implant cancer occurs more in women with textured breast implants as opposed to women with smooth-shell implants. According to the FDA, of the 272 instances that included information on the type of breast implant, only 30 were from smooth-surfaced implants.
Whether the implant is filled with saline or silicone gel, it does not seem to be a risk factor at this time, though sufficient testing is still underway. Out the 414 FDA confirmed incidents of BIA-ALCL, 234 implants were filled with silicone gel and 179 implants were filled with saline.
Are Certain Companies’ Breast Implants Unsafe?
As of now, several companies and their implant products are associated with breast implant-associated ALCL.
These manufacturers include:
- Johnson & Johnson (J&J)
- Mentor Worldwide LLC (acquired by J&J)
- Actavis
- Allergan (acquired by Actavis)
- Sientra
Is Breast Implant Cancer Fatal?
Breast implant-associated ALCL is classified by the FDA as uncommon cancer, with only 414 reported cases of the disease in total. Despite how rare BIA-ALCL is, it is a highly treatable cancer. Out of 595 cases reported worldwide, a total of 16 women have died from BIA-ALCL.
As with most cancers, the key to a favorable outcome is through early detection before the cancer metastasizes through the lymph nodes.
Who Is at Risk for Developing Breast Implant Cancer?
While BIA-ALCL is a risk for all women with breast implants, those with textured implants have a higher risk than those with smooth-surfaced implants. Women with this rare disease have usually experienced an allergic reaction to the textured implants. These reactions developed slowly over the course of several years. BIA-ALCL might also be caused by the body’s reaction to textured-implant particles or bacteria on the surface of the implant.
Textured breast implants have a rougher surface than smooth-surfaced implants. Smooth-surfaced implants account for around 88 percent of all implants. Based on data collected from the U.S., Canada, and the Netherlands by the American Society of Plastic Surgery (ASPS), the risk for BIA-ALCL ranges from one out of every 1,000 women with textured implants to one out of every 30,000 women with untextured implants.
At this time, the contents of the implants—whether silicone or saline—are not known to be a contributing factor to a person’s risk of developing breast implant cancer.
Whether your breast implants were for augmentation or reconstruction, the risk for BIA-ALCL is the same.
What Are the Symptoms of Breast Implant Cancer?
The symptoms of BIA-ALCL can often be mistaken for symptoms of other illnesses or diseases, but most commonly start occurring around eight to 10 years after breast implants. Symptoms will vary from person to person.
However, common breast implant cancer symptoms include:
- Spontaneous fluid buildup in or around the breast
- Pain or soreness
- Redness
- Swelling
- Breast enlargement or hardening
- Asymmetry of the breasts
- Lumps in the breast or armpit areas
- Overlying skin rash
Less commonly, contraction of the scar tissue surrounding the breast implant can occur. Because BIA-ALCL is a form of non-Hodgkin’s lymphoma, symptoms can suddenly appear through the body’s immune system in rare cases.
They include:
- General fatigue
- Unexplained weight loss
- Anemia
- Night sweats
What Tests Are Used to Determine Breast Implant Cancer?
Mammograms, while common for women over 40, are not considered very helpful for the testing and diagnosis of breast implant cancer. This is because breast implants—both silicone and saline—can interfere with standard mammogram X-rays and obscure their images.
Due to the fact that symptoms of breast implant-associated ALCL are similar across many other kinds of diseases and cancers, diagnosing BIA-ALCL can sometimes be very difficult.
Diagnostic testing for breast implant-associated illnesses can involve the following:
- Needle Biopsy and Drainage: Doctors use a needle to obtain samples of blood cells from the fluid near the breast. A pathologist will test the fluid for CD30 immune staining (CD30IHC), which will confirm or rule out breast implant-associated ALCL.
- Ultrasound: Using this imaging test, doctors can evaluate the area around the implant(s), including the lymph nodes for lumps or fluid buildup.
- PET Scan: With a PET scan, a doctor will look at the body as a whole for evidence of whether or not the disease has spread. Spreading then determines the cancer’s stage, and subsequently its prognosis and recommended a treatment plan.
- CT/CAT Scan: A method for creating cross-sectional pictures of bones, blood vessels, and soft tissues, these scans combine and overlay X-rays from many different angles to produce detailed images of potentially cancerous areas.
- MRI Scan: Used in radiology, a medical resonance imaging (MRI) scan will utilize strong magnetic fields to generate images of a person’s body and internal structures.
- Blood Tests: If doctors are not sure whether or not ALCL has spread through the lymph nodes, additional testing via blood test or a bone marrow biopsy might be performed.
How Is Breast Implant Cancer Treated?
Breast implant cancer is treatable in many cases through the surgical removal of the implant and its scar tissue capsule. This process is what’s known as an “explant” procedure. If the cancer has spread through the lymph nodes, a chemotherapy regimen may be recommended to shrink any tumors.
In advanced cases of BIA-ALCL, patients may need additional treatment through radiation therapy or stem cell transplant therapy, though this is very rare.
What Is the Survival Rate of Someone with BIA-ALCL?
The prognosis for women who have been diagnosed with breast implant-associated ALCL is very good, so long as the cancer is discovered before it spreads to other parts the body.
Because implant-associated ALCL often remains confined around the breast implant, this cancer’s survival rate is very high. Experts have identified that in 89 percent of all breast implant-associated ALCL cases, women have lived beyond five years after explant surgery.
What Should You Expect after Surgery?
After BIA-ALCL patients have undergone an explant procedure for the removal of their breast implants and capsules, doctors will continue to monitor patients through regular checkups in three- to six-month increments for at least two full years. Many doctors will require all post-surgery checkups to include PET or CAT scans. Re-occurrence with breast implant-associated ALCL is very rare.
