After Your Breast Implant Cancer Diagnosis
If you or a loved one has been diagnosed with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), you can usually expect a good prognosis. The overall survival rate for patients diagnosed with BIA-ALCL is 89 percent. This means that 89 percent of patients survive longer than five years.
The rate is significantly higher for patients with stage I BIA-ALCL. These women have high chances of living long-term progression-free. When caught early, the disease is highly treatable. It all hinges on whether you receive timely and appropriate treatment.
In most cases, treatment for BIA-ALCL involves minimally invasive surgical methods.
The type of treatment you receive depends on:
- The type and location of BIA-ALCL
- The type of breast implant
- The stage and progression of the cancer
- Your age and general health
ALCL breast implant treatment also depends on the results of various follow-up tests.
After your doctor has confirmed you have BIA-ALCL, they might recommend:
- Routine blood work to check for any other health issues
- Pregnancy testing, as cancer treatments can harm a fetus
- A bone marrow biopsy in rare cases of suspected metastasis (cancer spread)
- A PET scan, another test for metastasis
From the results of these tests, your doctor will work with you to develop a customized plan for removing the cancer and relieving your symptoms. In most cases, surgery alone is enough to treat BIA-ALCL. Additional therapies, such as chemotherapy or radiation, come into play when the cancer is unusually difficult to treat.
Let’s start with what you can expect from breast implant cancer surgery.
Surgery for Breast Implant Cancer
In rare cases when the cancer spreads, women might undergo a lymph node dissection to remove lymph nodes. However, for most patients, BIA-ALCL is localized and classified as stage I. The first step to successful recovery in these cases is explant surgery.
What Is an Explant?
The goal of explant surgery is to completely remove both implants and surrounding scar tissue. This scar tissue, known as the “capsule,” naturally develops as an immune response to a foreign object.
Your doctor will likely recommend one of two types of explant procedure:
- En Bloc: From the French term “as a whole,” en bloc surgery removes the implant and capsule as one unit to protect against silicone spillage. This is the gold standard of explant procedures and is advised for all silicone breast implants (both smooth and textured) and textured saline implants. However, this procedure takes time and experience.
- Total Capsulectomy: Sometimes confused with a capsulectomy, which refers to a partial tissue removal, a total capsulectomy removes all scar tissue, including a thin lining along the ribs and lungs. The surgeon first removes the implants, then removes any leftover capsule tissue. This procedure is advised for smooth saline implants.
Choosing a Surgeon and Questions to Ask
Whether you undergo en bloc surgery or a total capsulectomy, it is crucial that the capsule is fully removed.
Inexperienced doctors might insist that the capsule is too thin to fully remove, but skilled surgeons know otherwise. If left in the body, the capsule can harbor bacteria, continue to grow or trigger further autoimmune responses. There have been a few instances of partial removal where women wasted money on second surgeries.
Do your due diligence when choosing a surgeon. Ask questions that focus on the cost, the surgeon’s experience and their commitment to a full removal of the implant capsule. Also ensure their commitment to removing all silicone, which can release aggressive chemicals and heavy metals into the body.
After surgery, your implants may be returned to you upon request. This is something to consider if you wish to pursue legal proceedings against their manufacturer for failing to warn about associated cancer risks. You also have the right to request a copy of the surgeon’s pathology report, which records findings from examining your capsule.
Additional Therapies for Breast Implant Cancer
Patients with higher stages of BIA-ALCL might require further treatment. In addition to surgical treatment for BIA-ALCL, your doctor might recommend radiation therapy, chemotherapy or a combination of both.
Radiation therapy uses high-energy X-rays called photons to kill cancer cells that remain after explant surgery. A typical BIA-ALCL treatment plan involves several doses (or “fractions”) of radiation—usually five fractions a week for four to six weeks. When given after breast implant cancer surgery, radiation therapy can help prevent the cancer from coming back.
Chemotherapy uses powerful drugs to shrink tumors, control their growth or relieve cancer symptoms. You may need a single drug or a combination of two or more depending on the type and progression of your BIA-ALCL.
These drugs can be administered in one of two ways:
- Orally, in either pill or liquid form
- Injected into the muscle, under the skin or directly into a cancer lesion (a tumor or tumor-like formation)
Depending on the drug used, chemotherapy comes with side effects. The severity differs from patient to patient, but some side effects are more common than others.
Common side effects include:
- Hair loss
- Increased risk of infection
- Numbness or weakness in hands and feet
- Problems with memory and concentration
Most of these are temporary and disappear after BIA-ALCL treatment. Ask your doctor about complementary therapies to help alleviate chemotherapy side effects.
Healing and Recovery
The goal of the healing process is to restore the body’s equilibrium. This is done by supporting the organs and systems affected by a foreign interference (in this case, breast implants) and flushing any associated toxins which may have leaked out of the implants.
An explant is the first and most important step in this journey. You will then be scheduled for follow-ups, physicals and other necessary tests every three to six months for two years (or as needed). During this period, you can support your body’s natural restoration processes by focusing on the four key pillars of optimal health.
These four pillars are:
- Nutrition: An organic, low-sugar, non-GMO diet of dark leafy greens, healthy fats, protein and fiber
- Water: Half your body weight in fluid ounces
- Sleep: Uninterrupted for seven to eight hours after falling asleep within 20 minutes
- Exercise: Gentle, aerobic strength training that improves circulation to assist detoxification
Talk to your doctor about these and other ways to detoxify the body based on your specific needs. For example, as your body adjusts to the changes, some of your symptoms might dissipate only to return weeks later. It takes months, or even years, for some women to see significant improvements to their health, so be patient with your healing process.
As to whether it is safe to replace your implants, doctors are still unsure. For now, the safest course is to be wary of products with known links to BIA-ALCL, whose manufacturers knew of the dangers. Legal action is now helping the women they wronged to restore their quality of life.
That’s where our Breast Implant Cancer Advocates can help. As an extension of your care team, an advocate can answer any questions about steps to take during your treatment to hold these manufacturers accountable.