Receiving a breast implant cancer (BIA-ALCL) diagnosis is extremely difficult. One may experience frustration, anxiety, and fear, all of which are completely normal feelings. Navigating the first few days and weeks after a diagnosis of a rare disease can be overwhelming. It can be even more overwhelming when one has to weed through hundreds of pages of medical articles just to better understand their illness.
We understand these feelings. Breaking down a complicated cancer through numbers is not always the best solution, and it is important to remember that people are much more than mere numbers on a page.
That said, for many people, thinking about things through easy-to-understand numbers—percentages, totals, probabilities, and averages—is a good way to get a quick and holistic picture of highly complex data.
Often, a better understanding of the numbers serves to arm patients with the data they need to have more peace about their recent diagnosis.
By the Numbers: A Simple Overview of Breast Implant Cancer
If you were recently diagnosed with breast implant-associated ALCL, you have likely heard that this disease is rare. But just how rare is it?
Here is a breakdown of the fundamental dates and numbers that will help you better understand how many people have been impacted by this cancer and for how long.
Textured implants rose in popularity in the 1990s, and the first documented case of BIA-ALCL came in 1997.
In 2011, the U.S. Food and Drug Administration (FDA) identified a likely association between breast implants and the development of anaplastic large cell lymphoma (ALCL).
In 2016, the World Health Organization (WHO) acknowledged breast implants as a distinct cause of ALCL.
As of September 30, 2017, the FDA had received a total of 414 medical device reports (MDRs) connecting breast implants to BIA-ALCL. Of these 414 reports:
- 9 patients had died.
- 272 (of the 414) MDRs disclosed information regarding the surface type of the implant. Of these 272:
- 242 had “textured” implant surfaces.
- 30 had “smooth” implant surfaces.
- 413 (of the 414) MDRs disclosed information regarding the fill of the implant. Of these 413:
- 234 implants were filled with silicone gel.
- 179 implants were filled with saline.
A Closer Look at Breast Implants Themselves
To understand just how rare a disease like a breast implant cancer is, first take a look at the numbers regarding all breast implants. Then take a closer look at the odds of a woman with breast implants developing such cancer.
It is important to note that as of 2018, breast augmentation surgery remains the most popular cosmetic surgery in the United States—and it has been since 2006.
According to information gathered by the American Society of Plastic Surgeons (ASPS), around 4 million breast implant procedures occurred in the U.S. alone between 1998 and 2009.
In 2016 alone, ASPS estimates that over 290,000 American women received breast implants. Of these:
- 111,210 implant procedures were performed in patients between the ages of 30 and 39.
- 87,623 implant procedures were performed in patients between the ages of 40 and 54.
- 85,690 implant procedures were performed in patients between the ages of 20 and 29.
In 2017, ASPS saw a 3 percent increase in breast implant procedures, with 300,378 women receiving breast implants.
- Of these 300,378 implant procedures, silicone gel was used in 87 percent and saline was used in 13 percent.
Worldwide, the total number of breast implants is estimated to be somewhere between 5 and 10 million.
The Odds of Developing Breast Implant Cancer
No matter what way you look at it, the chances of a woman developing breast implant cancer are slim. That said, knowing the risks is vital and detecting the cancer as early as possible is key to beating it. Here is a look at the incidence and survival rates of BIA-ALCL.
The ASPS and the FDA contended that the incidence rate of BIA-ALCL is very low. The current lifetime risk is estimated to range from 1 woman out of every 3,817 with textured breast implants to 1 woman out of every 30,000 women with textured implants.
Though reports vary as to when BIA-ALCL develops, a few facts are clear:
- 50 percent of BIA-ALCL diagnoses occurred around 7 to 8 years after receiving breast implants, according to FDA MDR reports.
- For patients who received implants for cosmetic purposes, the average age of diagnosis was 46.
- For patients who received implants for breast-reconstruction purposes, the average age of diagnosis was 57.
- The overall average age for patients diagnosed with BIA-ALCL was 51.
In a study of 87 patients, nearly all women diagnosed with BIA-ALCL had early-stage cancer. The study reported that:
- Between 83 and 84 percent had stage I (confined to the capsule).
- Between 10 and 16 percent had stage II (possible spread to armpit area).
- Under 7 percent had stage IV (cancer had spread to other parts of the body).
In the same study of 87 patients diagnosed with BIA-ALCL, the overall survival rate (OS) was:
- 94 percent after 3 years.
- 91 percent after 5 years.
In both the 3-year and 5-year survival rates, 49 percent of patients were event free.
Looking at Lymphoma and BIA-ALCL Worldwide
It is important to remember that BIA-ALCL is not a type of breast cancer, which has its own set of data. Instead, BIA-ALCL is a very rare type of non-Hodgkin’s lymphoma that develops primarily in women with textured breast implants.
Additionally, contextualizing this rare disease can be difficult when we only look at figures from the U.S. In the statistics below, we take a closer look at lymphoma. Then, a global context helps to get a better picture of BIA-ALCL worldwide.
Non-Hodgkin’s lymphoma (NHL) is one of the most common cancers in the United States, accounting for 4 percent of all cancer cases.
The American Cancer Society estimates that in 2018 alone:
- 74,680 Americans will be diagnosed with non-Hodgkin’s lymphoma. Of those:
- 41,730 will be men.
- 32,950 will be women.
- 19,910 will die from NHL.
For the average American, the risk of developing NHL during their lifetime is 1 in 47 (1:47), or a 2.12 percent chance.
For a better understanding of the rarity of breast implant cancer, experts believe BIA-ALCL will account for only 1 to 2 percent of all cases of non-Hodgkin’s lymphoma.
Taking a look at other countries around the globe is important for contextualizing BIA-ALCL. When it comes to better understanding this rare disease, research is a multinational effort. Currently, research is being conducted in the U.S., Australia, Canada, and the Netherlands, among others. Here is a look at some of the global data:
Though data is incomplete and not all instances of BIA-ALCL have been documented, 590 known cases of BIA-ALCL have been diagnosed worldwide.
In Canada, 5 cases of BIA-ALCL have been reported to health regulators.
Around the globe, there have been a reported 16 deaths related to BIA-ALCL, 9 of which occurred in the United States. Of these 16 deaths:
- 13 patients died from the expansion of the cancer into their chest wall, which led to respiratory failure.
- 2 patients died from stem cell transplants.
- 1 patient died from the development of a second, unrelated cancer.
In a detailed analysis conducted by the New Zealand and Australian Therapeutic Goods Administration (TGA), 46 BIA-ALCL cases have been confirmed in New Zealand and Australia. Their documentation included the death of 3 women.
As of 2016, an additional 10 Australian women were diagnosed with BIA-ALCL.
When it comes to the risk of getting BIA-ALCL, the FDA contends that between 1 in every 3,817 women to 1 in every 30,000 women with textured implants will develop the disease. Other countries around the globe have produced varying risks:
- Similar data from Australia and New Zealand put the risk at 1 to 10,000.
- The Netherlands has identified a risk of 1 to 6,900 for women with textured implants.
- Health Canada’s risk for women with textured implants is 1 in 24,000.
Looking Past the Numbers Toward a Brighter Future
We know that numbers and data are not the be-all end-all, and they do not speak for all experiences. We also understand that people are not mere numbers on a page. That said, data and statistics can be important tools for coming to grips with something that feels truly overwhelming. Sometimes, seeing the numbers helps recently diagnosed patients understand that they are not alone despite what they may be feeling.
Additionally, numbers can help researchers and scientists build new hypotheses that can then be tested to produce more data. All of this information can help the world better understand rare and understudied diseases like BIA-ALCL. When researchers have more thorough information, the world moves one step closer toward solutions and a brighter future.
We hope that the numbers collected above help you to see BIA-ALCL in a different, but perhaps more holistic, way. As the study of breast implant cancer continues around the world, the numbers will change and grow along with it. Breast Implant Cancer Advocates will do its best to update this page accordingly, should any new major data be released.