It is important for patients considering breast augmentation to be informed about an association with a type of lymphoma.  Fortunately the type of lymphoma – referred to as breast implant associated Anaplastic Large Cell Lymphoma (ALCL) – is very uncommon and treatable in the majority of cases.  It was first reported in the late 1990s by the FDA and research is underway to better understand this condition and how to educate patients.  Here are four FAQ regarding breast implant associated ALCL:

What is breast implant associated ALCL?

Breast implant associated ALCL is a cancer involving cells of the immune system.  It is not a type of breast cancer.  It may occur at different body sites, including the skin and lymph nodes.  Breast implant associated ALCL generally involves the scar tissue that surrounds the breast implant as opposed to affecting breast tissue.  It appears to be linked with textured implants.  No definitive reports have been identified involving implants with smooth outer shells.   No differences have been identified between saline and silicone implants.  Studies continue to better define the risk of developing this condition.  The risk based on the best epidemiology studies is 1/300,000.  There have been 359 cases reported worldwide at time of this blog posting.

How does it present?

The most common presentation of breast implant ALCL is a late seroma, or fluid collection, around an implant a year or more after breast augmentation.  Patients may also present with localized pain or swelling, often years after breast augmentation surgery.  Occasionally the condition may present with a palpable mass on breast examination.

How is ALCL diagnosed?

If concerns arise following breast augmentation, it is important to present to your plastic surgeon for a thorough physical examination and work up.  If a late seroma is identified, fluid is taken through fine needle aspiration and sent for staining tests.  If sent for routine pathology testing, the condition may be missed.  Additional investigations and imaging will be ordered by a multidiscplinary team as part of work up and treatment.

What is the treatment for breast implant-associated ALCL?

ALCL is treatable in over 90% of cases.  Patients require implant removal as well as removal of the scar tissue around the implant (capsulectomy).  If the lymphoma has spread to the lymph nodes or other sites, chemotherapy or potentially radiation may be indicated.  Management will be determined by a team of specialists, including a plastic surgeon and oncologists with expertise in these areas.

Breast implant-associated ALCL remains a main focus area of plastic surgery research.  Although the association between breast implants and this form of lymphoma is quite rare, it is important for patients considering breast augmentation to be well-educated as part of the informed consent process.  This will allow patients to monitor for signs and symptoms years after breast augmentation and seek medical attention as soon as possible.

Please contact us if considering breast augmentation in the Toronto area to schedule a consultation with female plastic surgeon, Dr. Stephanie Power.

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