What Do We Know About the Lymphoma-Breast Implant Link?
Lymphoma is a blood cancer. The cancer linked to breast implants, known as anaplastic large cell lymphoma (ALCL), is a rare form of lymphoma that is classified as a non-Hodgkin lymphoma (NHL). According to the Federal Drug Administration (FDA), late-onset symptoms of ALCL, as it relates to breast implants, include breast pain, swelling due to a new seroma formation, or breast asymmetry. Although the lymphoma is detected around the site of the breast implant, in the breast, ALCL is not a form of breast cancer.
As a result of a 2011 FDA announcement, in partnership with the American Society of Plastic Surgeons and the Plastic Surgery Foundation, a medical registry was created to track cases of breast implant-associated anaplastic large cell lymphoma (BIA‑ALCL).
In March of this year, the FDA had gathered a total of 359 cases of BIA-ALCL. The 2017 report summarizes that, “most confirmed cases of BIA-ALCL have occurred in women with textured breast implants.”
Most importantly, the FDA report states,
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.
Nearly all implants used in breast reconstruction have a smooth, not a textured surface. Even though most tissue expanders are textured, they are in place for too short a period of time to be likely implicated by ALCL. The theory is that the texture in certain implants initiates a chronic inflammatory/biofilm phenomenon that initiates the lymphoma changes in rare instances.
Patient Recommendations For BIA-ALCL
Along with the new findings on BIA-ALCL, the recent FDA report also offers patient recommendations that take the new information into consideration. They recommend continuing with normal surveillance of the implants. Any changes in symmetry, pain, perception of fluid accumulation should be evaluated.
In addition, if screening ultrasound is indicated, and fluid is detected, the aspirated fluid should be sent for CD30 immuno-histochemistry, cytology and flow cytometry.
As long as there is no cellular invasion of the capsule surrounding the implant, ALCL follows a benign course. Cellular invasion of the capsule requires a complete capsulectomy (removal of the capsule), which is easily done. There have been several cases where more aggressive treatment is required.
The most important thing to do is not to worry! The link between breast implants and lymphoma is still being researched. With so few cases reported, not everything is understood yet about the association between the two. It is also extremely rare, so there is little likelihood of being affected by implant-related ALCL. As we always recommend at The Maurer Foundation, keep yourself educated, get regular screenings, and empower yourself to make educated decisions about your healthcare.