What's the media saying?
Recently a special council of plastic surgeons was asked to report to the Food & Drug Administration (FDA) their data on this very question. This has caused it to reach some main stream media and has left a lot of patients asking questions or being worried if their implants may cause cancer. So, let’s talk about do breast implants cost cancer.
Every year over 100,000 implants are placed in women for breast augmentation and breast reconstruction around the world. The overwhelming number of these women have no issues with their implants. However, recently there has been a cancer that it has rarely been found in women receiving a specific type of breast implant. This breast cancer is actually a form of lymphoma and is called Anaplastic Large Cell Lymphoma (ALCL). It is not cancer of the breast tissue itself but is a form of lymphoma that is thought to develop due to some of the mechanical properties of a specific type of breast implant. When diagnosed early the disease is easily curable and most patients receive an excellent prognosis.
How common is it to develop ALCL?
Although it is difficult to obtain exact data of how many women have breast implants, it is estimated that millions of woman have breast implants placed for breast augmentation and breast reconstruction around the world. To date there have been a total of 688 cases of ALCL reported worldwide (however, some of these cases are thought to be duplicates), making the overall incidence of this disease very low (less than 0.1% if patients).
What is the cause of ALCL?
Although we still do not fully understand the cause of this disease we do know the following. Every patient who has developed this disease has a textured surface implant. We believe the cause of this disease is related to the textured surface that has commonly been used on breast implants for many years. However, not all breast implants have textured surfaces. To date, no cases of ALCL have been reported in patients with only smooth surface breast implants. And for this reason, I only use smooth surface implants and do not use textured surface implants in my practice. More specifically it seems that this cancer is associated with one particular type of textured surface implant.
There is also thought to be a bacterial component of this disease. A large majority of cases grew a rare bacterium called Ralstonia picketti. It is unclear how this bacterium is linked to the disease because the bacteria did not cause the patient to present with an infection, but it seems to have an association with the disease. For this reason, I use an antibiotic solution at the time of surgery that kills Ralstonia and all other bacteria to eliminate the risk of this type of infection and thus decrease any chance of my patients developing ALCL.
What are the symptoms of Breast implant associated ALCL?
Typically, symptoms develop at an average of 8-10 years after initial surgery, but symptoms may develop sooner. The overwhelming majority of cases the disease presents itself as an effusion around the implant. For the patient this will present as swelling of the breast on one side that seems to happen for no reason and it may or may not be painful. The swelling can develop over a period of days or weeks. Rarely the disease can present as a mass attached to the capsule around the implant. This will present as a lump in the breast or firmness of the breast.
What is the treatment for ALCL?
In most cases the treatment for this disease is removal of the breast implant in the scar tissue around the implant called the capsule. The majority of women who undergo this treatment alone will be cured from this disease. Most patients will not require any form of chemotherapy or radiation treatment for the disease. The key is early detection and treatment and for your plastic surgeon to have a high index of suspicion for the disease.
Christopher Costa, MD, MPH
Disclaimer: This blog is meant to be informative only and should not be used as professional medical advice. There is still a lot that we are discovering about this disease and updated data may be more readily available. Please consult the FDA and the ASPS for the most current updates on ALCL.