Answering Your Questions about Breast Implant-Associated ALCL

Last week, on March 21st, 2017, the United States Food and Drug Administration (FDA) published a new update suggesting a possible association between breast implants and the development of a condition called anaplastic large cell lymphoma, or ALCL, a rare type of non-Hodgkin’s lymphoma.  Needless to say, this news has caused a great deal concern among women who have received textured breast implants for breast augmentation or breast reconstruction surgery, and many of our current and former patients have contacted us seeking more detailed information.  For nearly fifty years, Atlanta Plastic Surgery has been recognized throughout the medical community as one of the premier cosmetic and reconstructive plastic surgery centers in the Southeast, and we have always believed that patient safety and patient education are at the foundation of quality care.  Here are the answers to the most important questions about Breast Implant-Associated ALCL.

Answering Your Questions about Breast Implant-Associated ALCLWhat is BIA-ALCL?

According to the FDA, Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is an extremely rare disease that has affected a small number of women who have textured breast implants.  Although ALCL has been classified as a form of cancer by the World Health Organization (WHO), there is data to suggest that this classification may need to be changed as the disease behaves much more like a Lymphoproliferative Disorder.  It is important to know that ALCL is NOT breast cancer.  It is a highly treatable neoplastic-like lymphoma unlike anything else.

Am I at risk of having BIA-ALCL?

The FDA has found 359 medical device reports (MDRs) of women developing breast implant-associated ALCL over the past over the past 55 years of breast implant history.  While this is slightly higher than the number of women in the general population who develop ALCL, it is still statistically a very small number, considering that an estimated 1.7 million breast implantation surgeries were completed in the United States in the last six years alone.  In fact, the risk of developing BIA-ALCL, which is estimated to be about 1 in 30,000, is actually much lower than the risk of developing almost any other form of cancer.

What kinds of breast implants are affected?

This FDA advisory has associated BIA-ALCL specifically with textured breast implants.  This is based on the fact that the majority of women who developed the condition, 203, had a textured type of implant rather than a smooth implant and the theory that textured implants may have a higher risk of BIA-ALCL because they offer a “medium” – more surface area for bacteria to grow in and around.  However, studies are still ongoing and no definitive conclusions have been made.  Most breast implants used in the United States are smooth, not textured, and there are currently no confirmed cases of BIA-ALCL in patients whose implant history includes only smooth implants.

Is there anything that I can do to minimize my risk?

The FDA stresses that women with breast implants do not need to change their routine care and medical follow-ups, nor do they recommend the removal of implants in asymptomatic patients who have no identifiable abnormalities.  Patients with textured implants should be alert to any changes in the shape and/or size of their breasts, as inflammation can be a tell-tale sign, and should definitely get checked if they are experiencing any pain or unusual swelling.  Treatment usually involves the removal of the implant and the capsule that surrounds it, a relatively common procedure that is used to treat capsular contracture as well, but in some cases may involve chemotherapy and radiation as well.  Treatment has proven to be extremely effective, and all known cases of BIA-ALCL that were promptly diagnosed and treated have been cured.

You can get more detailed information on Breast Implant-Associated ALCL, as well as additional patient advice, in the joint advisory statement recently published by The American Society of Plastic Surgeons (ASPS) and The American Society for Aesthetic Plastic Surgery (ASAPS), as well as in this educational video produced by The Plastic Surgery Channel™.   If you have additional questions about any of the reconstructive or cosmetic plastic surgery procedures that we perform, please contact Atlanta Plastic Surgery, P.C. at our Atlanta, Alpharetta, Cumming, or Newnan office to schedule an appointment for a consultation.  Don’t forget to follow us on Facebook, Twitter, and Google+ for the latest plastic surgery news.