Image above from Bernhard Oppenheim /Getty Images
According to the FDA, 9 women have died from anaplastic large cell lymphoma (BIA-ALCL) possibly associated with their breast implant use. The FDA received 359 reports of BIA-ALCL, a rare type of non-Hodgkins lymphoma, 9 of whom died as of February 1, 2017.
Lymphomas make up the most common of the blood cancers. The cancer begins in the lymphocytes, cells crucial for maintaining one’s immune system. Two main types of lymphoma are Hodgkin’s and Non Hodgkins. Non Hodgkins is more common, and anaplastic large cell lymphoma is a subset if it.
Anaplastic Large Cell Lymphoma/pathpedia.com
This is not the first time a link has been suggested. 6 years ago the World Health Organization suggested a link. Then in 2011, the FDA identified a possible association between the two. In 2016, the Australian Therapeutic Goods Administration reported 46 confirmed cases with 3 deaths relating to breast implants.
Now the texture of the breast implant may also affect the cancer growth. According to the FDA, 231 of the 359 reports provided information on implant type. 203 were reported to be textured implants and 28 reported to be smooth implants. When it came to silicone vs. saline implants, the FDA said 312 of the 359 reports provided these specifics and of those 186 reported implants filled with silicone gel and 126 reported implants filled with saline.
So neither implant type appeared immune to the risk of BIA-ALCL but it appears the silicone, textured implants carried the most risk.
Now the cancer occurred within the breast and the FDA advises physicians to consider the possibility of BIA-ALCL if there appears to be a seroma (fluid filled cavity around the implant) or a contracture (pulling of the skin and tissue) near the implant.
In most cases the cancer is treatable, with removal of the implant and the surrounding tissue curative. In some cases however, radiation of the area or chemotherapy is required.
Although 50,000 cases of non-Hodgkins lymphoma occurs annually in the US, it is unknown how many cases of BIA-ALCL occur each year. Moreover, many countries may not have avid reporting systems of breast implant related cancers as we do. According to the American College of Plastic Surgeons, close to 300,000 women receive breast implants each year, some of which for breast reconstruction after mastectomy for breast cancer.
The FDA reminds us that BIA-ALCL is rare and prophylactic breast implant removal is NOT recommended. However we need to be aware and evaluate if one develops swelling, pain, new lumps or asymmetry in the breasts….just as we do for those without implants.