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BIA-ALCL (Breast Implant Associated Acute Large Cell Lymphoma): dispelling the myths

Posted by Laurence Weider on July 10, 2018

BIA-ALCL (Breast Implant Associated Acute Large Cell Lymphoma): dispelling the myths

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.

What is BIA-ALCL?

BIA-ALCL is a rare and highly treatable form of lymphoma that can occur in the tissues surrounding breast implants.

Who is at risk?

Although it is rare, ALCL can occur in patients who had textured surface implants placed at least one year and typically several years earlier.

How common is it?

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.

What are the usual symptoms?

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.

What should I do if I develop one or more of those symptoms?

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.

What type of treatment is necessary.

In many patients, removing the implant and the scar capsule around it are curative. However, if the ALCL has spread, chemotherapy may be needed.

Does Dr. Weider use textured implants?

Very rarely. I almost always use smooth surface breast implants, and there is no clear association between smooth surface breast implants and ALCL.

How many implants are placed per year in the United States?

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.

How many cases of BIA-ALCL are reported per year.

Less than 100 cases of BIA-ALCL are reported per year.

Dr. Weider, a native of Southern California, is a Board-Certified Plastic Surgeon who has maintained a private practice in Dallas, TX since 1999. After attending Stanford University, he obtained his medical degree (M.D.) from Baylor College of Medicine in Houston. He then completed a one year surgical internship in Los Angeles at Harbor-UCLA Medical Center, followed by a four year general surgery residency in Dallas at Methodist Medical Center, and a two year plastic surgery fellowship in Cleveland at Case Western Reserve University.

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