The Surgeon Minute

Putting Breast Implant-Associated ALCL Into Perspective

Putting Breast Implant-Associated ALCL Into Perspective

Yes, Breast Implant-Associated Anaplastic Large-Cell Lymphoma (BIA-ALCL) is a cancer, but it is extremely rare. Yes, it’s associated with a certain type of breast implant, but it is curable!

BIA-ALCL absolutely requires the attention of patients and surgeons alike, but perspective is also required. Whenever a warning is raised about any type of cancer – even a rare one – and breast implants, it’s easy to send patients considering breast augmentation running for cover. Such announcements are far less grave than media outlets would lead viewers to believe. The announcement just needs to be unpacked by surgeons and physicians in the know to put the issue in perspective and quell any unheeded concerns. This is certainly true with the latest news about certain breast implant patients and a type of lymphoma.

What to Know About ALCL

1.  The proper, complete name is Breast Implant-Associated Anaplastic Large Cell Lymphoma, or BIA-ALCL.

2. BIA-ALCL is an extremely rare illness occurring in some breast implant patients.

3. Despite more scientific data being collected, so far no epidemiological study has shown a cause and effect relationship between ALCL and breast implants.

4. The chances of being diagnosed ALCL are incredibly rare. The FDA says between 1-in-1000 and 1-in-10,000 women with breast implants may be affected. Compare this to breast cancer, which affects 1-in-8 women, and patients will understand just how rare it is. A woman with breast implants is 10-200 times more likely to be hit by lightning than to contract this rare lymphoma.

No Need to Fear Armed with Education

Bruce Van Natta, MD, a board certified plastic surgeon in Indianapolis, said it’s important not to ignore the issue, but to keep everything in focus.

Breast implant-associated ALCL.

“Whenever someone’s diagnosed with cancer, obviously it’s scary. But let me just try to clarify some of this,” begins Dr. Van Natta. “It is incredibly rare. It’s real easy to not keep it in perspective, what with a lot of overly negative media attention. Suddenly it looms large, but in reality there have just been 300 or so patients in the world that have been diagnosed and identified out of the many millions and millions and millions of women who have had breast implants.”

“It may just be the perfect storm”

Dr. Van Natta says it appears that an assortment of ingredients have to come together in order for ALCL to develop.

“There’s also some other interesting things about ALCL,” says Van Natta. “It’s been largely associated with textured implants. There seems to be a particular bacteria as well and there may be a genetic component. For example, no Asian woman has ever been diagnosed, so it may just be it’s a perfect storm situation where these things come together.”

Warning Sign(s) for ALCL?

“ALCL in the breast is typically manifested by a little seroma, which is a collection of fluid,” Dr. Van Natta says. “So if a woman has had breast implants in and 9-10 years down the road suddenly for no obvious reason she’s got some swelling and we figure out it’s fluid say around the implant, it’s really important that fluid should be tested.”

The unlikely possibility of contracting ALCL is yet another item on the long list of reasons why patients need to see a board certified plastic surgeon for breast augmentation. These surgeons will follow their patients for years, checking to make sure everything is going great and that their patients are happy. If there are any concerns – such as the those noted by Van Natta – then you’ve got a surgeon who knows you, knows your procedure, and can help address any questions – or perform further surgery if necessary.

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