Dr. Jugenburg's Blog

25 March 2017

ALCL and Breast Implants

fake look breast augmentationALCL (anaplastic large cell lymphoma) is a very rare subtype of Non-Hodgkin Lymphoma which recently received a lot of media attention for a possible association with breast implants.

ALCL is NOT breast cancer.

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Essential facts:

  • ALCL is an extremely rare blood borne cancer (not breast cancer)
    • Since 1997, there have been only 173 patients world-wide identified as having BIA-ALCL
    • Overall risk is 3 in 100 Million women per year (very rare)
  • BIA-ALCL tends to present as late onset seroma in patients with textured breast implants
    • Typical patient has had textured breast implants for 8 years and develops a seroma (serous fluid collection around the implant)
    • There seems to be no association with smooth surface breast implants
  • Diagnosis is based on the aspiration of the peri-implant fluid which is assessed with immunohistochemistry for CD 30-positive and ALK-negative T-cell lymphocytes.
    • PET‐CT and MRI scans are investigations performed following a positive diagnosis
    • Mammograms are not helpful.
  • Patients with BIA-ALCL have an excellent prognosis when the implant and the surrounding capsule are completely removed
    • The majority of patients can be cured of their disease by bilateral total capsulectomy and implant removal.
    • Rare patients will present with a mass and have an increased risk of requiring radiotherapy and chemotherapy.
    • 93% of patients are disease free at 3 years when treated appropriately
  • There have been 9 deaths WORLDWIDE
    • None of these patients were treated with removal of the implant and the entire capsule, which is the recommended treatment.

Why is there a suspected link between ALCL and Breast Implants?

Although the total number of ALCL cases in women with breast implants is extremely low, it is higher than would be normally expected.  These cases ALCL seem to follow fairly consistent patterns, including the close proximity of the tumor to the breast implants and the type of tumor pathology. Because of this, the FDA believes that ALCL which develops in the scar capsule adjacent to the implant may be related to the implant presence.

When ALCL does occur, it has been identified most frequently in patients undergoing implant revision operations for late onset (mean time 8 years), persistent seroma. The FDA does not recommend prophylactic (preventative) breast implant removal in patients without symptoms or other abnormalities.

Should women avoid getting breast implants?

Because the risk of ALCL appears very small, FDA believes that the overall evidence continues to support a reasonable assurance that FDA-approved breast implants are safe and women can continue to undergo breast augmentations with FDA-approved breast implants.

Breast Augmentation

Breast augmentation is one of the most common cosmetic surgery procedures, and it is the most commonly performed procedure by Dr. Jugenburg (Dr6ix).  Check out our page on this topic, and browse several related articles found in our “Guide to Breast Augmentation” found on the left side of the Breast Augmentation page.