BIA-ALCL
There has been a lot of recent media attention regarding the risk of a certain type of cancer associated with breast implants, known as
Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).
What is BIA-ALCL?
BIA- ALCL is not a type of breast cancer. Rather, it is a rare type of lymphoma that has been predominately found in women with textured (as opposed to smooth) silicone breast implants.
what is the risk of developing bia-alcl?
The Food and Drug Administration (FDA) estimates that there are 5 million to 10 million women worldwide who have breast implants. As of October 2019, 573 cases of BIA-ALCL have been pathologically confirmed and 288 are suspected cases but not confirmed.
In the USA, approximately 550,000 total breast implants are placed per year, and of those, 70,000 were textured.
If you are unsure if you have a smooth or textured surface breast implant, ask your plastic surgeon.
How would I know if I am developing BIA-ALCL?How is it diagnosed?
Per the FDA and the American Society of Plastic Surgeons (ASPS), women without breast changes do not require more than routine mammograms and breast exams.
The most common symptom reported is usually swelling of the breast, often caused by fluid surrounding the implant. Other symptoms of BIA-ALCL include pain, lumps, and asymmetry between breasts. Some women have reported enlarged lymph nodes.
The fluid may be seen on ultrasound and a sample can be tested in a laboratory to confirm the diagnosis.
How is BIA-ALCL treated?
The recommended treatment of BIA-ALCL is surgery to remove the breast implant and the surrounding scar tissue layer, or capsule.
Implant and capsule removal is considered the definitive treatment in the majority of patients diagnosed with BIA-ALCL.
A small subset have gone on to receive chemotherapy.
Should I have my implants removed because of BIA-ALCL?
Currently, neither the FDA nor any Plastic Surgery society recommends that women should preventatively remove textured breast implants to prevent BIA-ALCL.
This is not a disease of breast tissue, rather it is related to the texturing of the implant device. Case reports of the same disease have recently been described in textured gluteal implants.
However, there are women who have been concerned enough about BIA-ALCL and have chosen to have their implants removed. Allergan, one of the major manufacturers of textured breast implants, issued a voluntary recall of textured implants for patients desiring removal.
Additionally, there are some women who were already considering a breast implant revision, and the BIA-ALCL issue gave them one more reason to decide to proceed. Some women are having textured implants replaced with smooth surface implants, and others are requesting explantation with no further implant placement.
Where can I find additional information and resources about BIA-ALCL?
For the most up-to-date information regarding this condition, I suggest visiting the Food & Drug Administration (FDA) website pertaining to BIA-ALCL