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BIA-ALCL (Breast Implant Associated Acute Large Cell Lymphoma): dispelling the myths
Posted by Laurence Weider, MD on July 10, 2018
In the last few years a concern has surfaced over the possible risk of cancer after breast implant surgery. Many of the reports have presented startling statistics that are not at all accurate. I would like to use this opportunity to provide some accurate statistics in order that potential breast implant patients have a more realistic understanding of the connection between the implants and the risks.
BIA-ALCL is a rare and highly treatable form of lymphoma that can occur in the tissues surrounding breast implants.
Although it is rare, ALCL can occur in patients who had textured surface implants placed at least one year and typically several years earlier.
The lifetime risk of the development of ALCL in women with textured surface implants is estimated to be somewhere between 1 in 3800 to 1 in 30,000.
Typically, ALCL presents with enlargement of a breast, pain, breast hardening, a lump in the breast or armpit or a large fluid collection around the implant. It occurs in someone who had an implant place at least one year and usually several years earlier. Only textured surface implants have been confirmed to put a woman at risk of the development of ALCL.
You should contact your surgeon who will arrange for biopsy with drainage of any associated fluid for testing. If the testing shows evidence of ALCL, a scan such as a CT scan will be performed to help determine if there has been any spread of the disease.
In many patients, removing the implant and the scar capsule around it are curative. However, if the ALCL has spread, chemotherapy may be needed.
Very rarely. I almost always use smooth surface breast implants, and there is no clear association between smooth surface breast implants and ALCL.
Approximately 550,000 breast implants are placed per year in the United States. This includes implants placed for both cosmetic and reconstructive reasons. About 70,000 of these are textured surface implants.
Less than 100 cases of BIA-ALCL are reported per year.