Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) has recently been the focus of media coverage and increased FDA investigation. This focus is warranted, BIA-ALCL is a serious diagnosis associated with breast implants that in extreme cases can be life threatening. Anaplastic Large Cell Lymphoma is a type of non-Hodgkin’s lymphoma, a cancer of the cells of the immune system, not a cancer of the breast tissue. Our understanding of how this cancer develops is evolving as more information is gathered and analyzed by the FDA. So let us review what we know about BIA-ALCL, including the recommended treatment and how this affects those of you who are considering breast augmentation or have previously undergone a breast augmentation surgery.
Included with each section is the timestamp from the video above where you can watch/listen to the relevant information.
38:51 to 40:54
Important facts you need to know about about BIA-ALCL:
- Per the reported cases, the median time of presentation is 9 years AFTER breast augmentation surgery and it is most commonly diagnosed at the time of breast revision/replacement surgery.
- To date, the diagnosed cases of BIA-ALCL have primarily been associated with textured shell breast implants and to a much lesser degree (5-6%) smooth shell breast implants. There are confirmed cases with silicone gel and saline breast implants.
- In most recorded cases, this disease development is limited to the affected breast and associated lymph node basin. This disease rarely involves the whole body.
- This is an extremely rare medical diagnosis. As of September 2018 the FDA has identified only 457 unique cases of BIA-ALCL, including 9 patient deaths.
- Currently there is no test available to see if you are susceptible to developing this condition.
40:58 to 41:24
Symptoms that may alert you to the development of BIA-ALCL:
- Asymmetric swelling or hardening of one breast, most often associated with a fluid collection around the breast implant.
- New onset development of breast pain
- Palpable masses in your breast and/or armpit
- Skin changes around your breast including rashes
41:26 to 42:27
If you are concerned that you may have BIA-ALCL, the medical workup will most likely include:
- An initial physical exam by your doctor
- Next step is an evaluation of your breast by an MRI exam
- If there is a concerning finding like fluid around the breast implant, an Ultrasound will be used to obtain a sample
- The fluid sample will then be reviewed by a pathologist for evaluation and, if detected, diagnosis of BIA-ALCL
42:30 to 43:10
If you are diagnosed with BIA-ALCL, the treatment will most likely include:
- Complete surgical removal of the breast implant and the scar capsule that has formed around the breast implant
- A course of chemotherapy guided by an oncology team
- Monitoring for 5 years which will likely include periodic breast MRIs
43:11 to 45:33
BIA-ALCL is a rare but serious disease that in the majority of cases is treatable and curable. If you currently have breast implants please remember that because this is an extremely rare diagnosis your risk of developing BIA-ALCL is very low. For those considering breast augmentation surgery, educate yourself on the signs and symptoms of this condition, along with all known risks of breast implants. This knowledge will allow you to proceed with confidence in your decision. Research into this disease is ongoing and I expect our understanding of how this disease develops to increase in the next few years. To learn more, watch the video above or listen to our podcast on Breast Implant Controversies where we discuss BIA-ALCL in detail.
Beauty and the Surgeon
Beauty and the Surgeon is an educational and empowering podcast that delves into all aspects of cosmetic surgery, plastic surgery, aesthetic medicine, beauty, fitness and personal health. Dr. Jason Martin is a renowned board certified plastic surgeon with offices in Aspen and Denver, Colorado.
Listen to Episode 45: 'Breast Implant Controversies'