Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare cancer of the immune system that occurs in people who have had breast implants. It is not breast cancer, but rather a type of lymphoma that grows in the scar tissue (capsule) surrounding the implant.
What is the risk of BIA-ALCL?
The risk of BIA-ALCL is estimated to be between 1 in 1000 and 1 in 10000, meaning 1 woman will be diagnosed with BIA-ALCL for every 1000 to 10000 women with breast implants.
All Australian cases have occurred in women with textured implants (and no cases in women with smooth implants). The risk of BIA-ALCL is significantly higher for "macro" textured (e.g. Silimed Polyurethane, Allergan Biocell) compared to "micro" textured (e.g. Mentor Siltex) implants. BIA-ALCL occurs with both saline and silicone filled implants.
There is no difference in risk in women who have implants for breast augmentation or reconstruction.
What are the symptoms of BIA-ALCL?
The main symptoms of BIA-ALCL are persistent breast swelling or pain. It can also present as a lump in the breast or armpit. Most cases occur between 3 and 14 years after surgery.
How is BIA-ALCL diagnosed?
An ultrasound is performed to assess for the presence of fluid. If fluid is present, a sample will be taken to look for cancerous cells. Fluid collections (seroma) is common after breast implants and most are not BIA-ALCL. Mammograms are not helpful for the diagnosis.
What is the treatment for BIA-ALCL?
Most patients with BIA-ALCL are cured by removing the implant and the surrounding capsule.
Should implants be removed, "just in case" of BIA-ALCL?
It is currently not recommended that breast implants are removed in people without any symptoms. However, breast implants are not lifetime devices regardless of BIA-ALCL. Please discuss with your surgeon about regular implant checks or if you have concerns.
Our Implant Story
Theatre nurse Janis Livingstone, 67, was diagnosed with hereditary breast cancer in 2001. Her daughter, Sarah, was diagnosed with breast cancer in 2015.
"I originally had implants, but they started to encapsulate last year (become hard and misshapen). I also knew a lady with breast implants who developed ALCL and I chose to have them removed and have a TRAM-flap instead (own tissue from abdomen)," says Janis.
However, Sarah, who was treated with a 9 cm aggressive lobular cancer, opted for breast implants. "I'm comfortable with my decision because I am regularly monitored and trust my surgeon."
Breast Implant Cancer was published in On the Coast Over 55 Magazine.