Rare Cancer Linked To Breast Implants

A total of nine deaths, linked to a rare form of cancer that is associated with breast implants, have been reported to the US Food and Drug Administration (FDA). The cancer is known as Anaplastic Large Cell Lymphoma (ALCL) and it impacts cells that are found in the immune system as well as the area around the breast implant. However, it is not a type of breast cancer and it can be found in the lymph nodes or the skin. Common symptoms of this rare type of cancer include breast enlargement, pain, asymmetry, a lump in the breast or armpit, overlying skin rash, hardening of the breast or a large fluid collection developing more than one year after receiving an implant (on average after 8 to 10 years).

Breast Implants and Rare Cancer Case Study

In cases studies, BIA-ALCL is usually located near the breast implant. It is contained within the fibrous scar capsule and not in the breast tissue itself. Conversely, developing around the breast and implant does not mean BIA-ALCL is breast cancer. It is categorized as a slow-growing type of non-Hodgkin’s lymphoma AKA a disorder of the immune system. BIA-ALCL appears primarily around the breast implant between the capsule and the implant. The progression of the disease happens when left untreated which involves its spread around the capsule and tissues. This progression is gradual and half of all cases of BIA-ALCL reported to the FDA have been associated with seven to eight years of implant surgery. According to the American Society of Plastic Surgeons (ASPS), symptoms can appear anywhere from 2-28 years after the procedure. The advice given to patients is to always consult a doctor or plastic surgeon immediately after they notice swelling of the breasts after an implant.       

FDA Addresses Rare Cancer and Breast Implants

According to the FDA, “All of the information to date suggests that women with breast implants have a very low but increased risk of developing ALCL compared to women who do not have breast implants”. As of February 1st, 2017, the agency had received a total of 359 reports of possible breast implant-associated cancer cases. They did caution that the exact number of cases related to this medical issue is not easy to determine because of large imitations in the number of reports across the world and a lack of sales data about global implant sales.

After six years of studying, the FDA discussed the risk of cancer developing in women after getting breast implants from 2011–2017. The FDA asked doctors if they had noticed any kind of changes in their patients. These women were asked to look for symptoms related to the issue such as a mass around their implants and any hardening in the area. One distinct feature is that a large number of cancer cases have occurred in people who have implants with textured surfaces rather than smooth surfaces. In fact, 203 cases reported to the FDA involved patients with textured surfaces. There have not been any records of BIA-ALCL in women who have had only smooth-walled implants. Thankfully, the FDA reports that most of the ALCL cases are slow-growing and can be treated if they are detected early enough.

In 2019, Allergan was asked by the FDA to recall some specific models from the U.S. market due to the risk of breast implant associated ALCL called BIA-ALCL. The BIOCELL textured implant products had been issued worldwide and the aggressive surface of this product has been discovered to have six times greater risk for ALCL than other textured surfaces. Approximately 5\\% of the breast implants sold in the United States is BioCell textured products. In the most recent reports, 573 cases of BIA-ALCL worldwide, along with 33 deaths, have been recorded from the cancer and are clearly linked to the Allergan Biocell Implants.

Steps for Treating Rare Cancer Linked to Breast Implants

Below is a step-by-step treatment of ALCL:

• After diagnosis of ALCL in a woman, she should have a PET/CT scan to look for any disease that may have spread throughout the body. The spread of the disease determines the cancer stage which is important in determining the treatment plan.
• Diagnosed patients should be referred to an oncologist for evaluation of ALCL, staging of the disease and for treatment planning.
• For patients with ALCL only, surgery should be performed to remove the breast implant and the scar capsule around the implant.
• Other patients with advanced cases may need to undergo chemotherapy, radiation therapy or stem cell transplant therapy.

Breast Implants Continue to be Popular

Breast implants are still very popular and is often the number one cosmetic surgery in the United States according to the American Society of Plastic Surgeons. Patients who are thinking about getting breast implants need to discuss the pros and cons of the procedure with a board-certified surgeon. An experienced surgeon can explain the risks and benefits of smooth and textured implants so a patient is able to make an informed decision about having the procedure. For those patients who have received breast implants, the most important thing to do is maintain regular checkups with a board-certified surgeon. At the earliest notice of any changes in the size or shape of the breasts, patients should make an appointment with a doctor for an examination. Timely recognition and intervention is the key to curative treatment when it comes to BIA-ALCL.