By Matthew S. Kilgo, MD, FACS

This is a question that occasionally comes up during my consultations with patients considering breast implant surgery. The answer is no, breast implants do not increase the risk of breast cancer. However, breast implants have been linked to a rare form of non-Hodgkins lymphoma known as breast implant associated anaplastic large cell lymphoma (BIA-ALCL). 

BIA-ALCL is not breast cancer. It is a cancer of the lymphatic system that develops within the scar tissue and fluid surrounding breast implants. BIA-ALCL most frequently occurs in patients with implants that have a rough, or textured surface. The estimated risk for those patients ranges from 1:2,207 to 1:86,000.* While the risk varies based on implant manufacturer and type of textured surface, cases have been reported for both cosmetic and reconstructive breast surgery patients. To date, there have been no confirmed cases involving patients who have had only smooth breast implants.

The most common symptom is swelling of the breast caused by a delayed seroma (fluid collection) that forms around the implant. This typically occurs years -almost 10 on average- after the breast implant surgery. Other less common symptoms include a lump in the breast, swollen lymph nodes in the armpit, a skin rash, fever, night sweats, pain, hardening, and/or a change in the shape of the breast. 

Patients who develop BIA-ALCL require treatment, which most commonly involves removal of the implant and surrounding tissue (en bloc capsulectomy). While most patients are cured with surgery alone, those who present with more advanced disease may require radiation therapy or chemotherapy. Patients treated for BIA-ALCL typically do very well with a 93% disease-free survival at 3 years.* 

Because BIA-ALCL is such a rare and treatable disease, the FDA does NOT currently recommend removing textured breast implants for those patients who have no symptoms. Patients with textured implants should familiarize themselves with the signs and symptoms of BIA-ALCL. Any patient who develops symptoms should be evaluated by their physician and make an appointment to see a board-certified plastic surgeon. 

For additional information about BIA-ALCL, the website of the American Society of Plastic Surgeons offers a great deal of information for patients.

You can also visit the FDA’s website for answers to commonly asked questions about BIA-ALCL. 

 

*Source: BIA-ALCL Resources: By the numbers, and what they mean https://www.plasticsurgery.org/for-medical-professionals/health-policy/bia-alcl-physician-resources/by-the-numbers