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Featuring Theodore T. Foley, MD

There are many reasons why women choose to have breast implants. Some may seek reconstruction after their breasts are removed as part of breast cancer treatment. Whether a woman is seeking to feel “normal” again or to improve self-esteem and enhance body image, breast implant surgery carries risk like all other surgeries.

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Breast implants linked to rare lymphoma

Recently, anaplastic large cell lymphoma (ALCL) was found in some women with certain types of breast implants. In these cases, this rare form of cancer grows around the implant, within the capsule of scar tissue that forms after surgery. It is usually treatable and not often fatal. But what causes this type of cancer to grow here?

What is breast implant-associated anaplastic large cell lymphoma?

Anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin lymphoma (NHL), a cancer that involves the cells of the immune system. ALCL is characterized by abnormal growth of T-lymphocytes, or T-cells and protein. According to the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, approximately 1 in 500,000 women is diagnosed with ALCL in the United States each year.

ALCL, when it happens around a breast implant, is called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). BIA-ALCL is rarer than ALCL. Approximately 359 cases have been reported out of approximately 10 million women with breast implants worldwide

Studies have shown that BIA-ALCL is more likely to occur with textured implants, which have a rough surface, rather than with smooth implants. Textured implants are typically used because the small grooves in the implant grow into the breast capsule and prevent the implant from rotating. According to the U.S. Food & Drug Administration (FDA), there have been 359 reported cases of ALCL in the breast and of those cases, 203 women had textured implants. Most of the patients with BIA-ALCL who have smooth implants previously had a textured implant. However, just because women have textured implants does not mean that they will develop ALCL.

When analyzing these reported cases, another factor that was considered were the contents of the implants in women with ALCL. The contents, whether silicone gel or saline, do not seem to have an effect on whether or not a woman will develop this type of lymphoma.

Research has not confirmed what exactly causes the cancer to form, but implant texturing, bacteriologic contamination and genetic factors have been implicated and are being investigated.

Bacteria have been identified within the capsule around the implant possibly a long-term inflammatory response to the presence of these bacteria is one of the factors that may cause BIA-ALCL.

Genetic factors may also play a role. The Australia/New Zealand risk to develop BIA-ALCL appears higher than other geographic areas.

How can women detect breast implant-associated anaplastic large cell lymphoma?

There are symptoms women can look for to help detect BIA-ALCL, including:

  • Completing self-breast exams to feel for abnormal lumps that could have recently developed.
  • Alerting a doctor of any sudden fluid buildup, swelling or pain.
  • Assessing the incision site for any redness, swelling or pain.

How is it treated?

In many cases, removing the implant and the scar tissue (capsule) around it eliminates the disease. However, some women may need chemotherapy or radiation treatments to fully eliminate it. As with any cancer, treatment varies from woman to woman and can be more severe in some cases.

This form of lymphoma is extremely rare. However, women who have or are considering breast implants should be aware of the potential problem and the increased risk of getting BIA-ALCL with textured implants and should consult a doctor to discuss the risks and benefits of the procedure.

If you are experiencing any of the symptoms relating to BIA-ALCL or need additional information, please contact our Breast Care Center.

About UPMC Harrisburg

UPMC Harrisburg is a nationally recognized leader in providing high-quality, patient-centered health care services in south central PA. and surrounding rural communities. UPMC Harrisburg includes seven acute care hospitals and over 160 outpatient clinics and ancillary facilities serving Dauphin, Cumberland, Perry, York, Lancaster, Lebanon, Juniata, Franklin, Adams, and parts of Snyder counties. These locations care for more than 1.2 million area residents yearly, providing life-saving emergency care, essential primary care, and leading-edge diagnostic services. Its cardiovascular program is nationally recognized for its innovation and quality. It also leads the region with its cancer, neurology, transplant, obstetrics-gynecology, maternity care, and orthopaedic programs.

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