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Is there a link between breast implants and ‘BIA-ALCL’ or ‘Breast cancer’?

In recent times there has been a lot of media attention surrounding the possible link between Breast implants and a particular form of cancer (BIA-ALCL).

BIA-ALCL refers to breast implant associated Anaplastic Large Cell Lymphoma. BIA-ALCL is different to what we commonly refer to as breast cancer, the latter arises from breast tissue. BIA-ALCL is a rare form of lymphoma that may be linked to breast implants. It is important to be aware of this possible association, but not to immediately panic and see a plastic surgeon about implant removal.

The first point to note that is that BIA-ALCL is rare. There are just over 380 cases detected world wide. This number needs to be considered in the context of over 60 million implant insertions around the world. To date, all cases of BIA-ALCL have been found only in women who had textured (and not smooth) implants. In those cases of BIA-ALCL, the incidence also appears to higher in those implants that had a greater degree of surface texturing.

Breast implant surfaces can be macro-textured, micro-textured, or nano-textured. The incidence BIA-ALCL cases in women who had macro textured implants appears to be approximately ten times that of the incidence in the women who had micro-textured implants. Hence the incidence of BIA-ALCL ranges from 1 in 4000 to 1 in 60,000, depending on the type of surface texturing present on the implant.

Based on these rates of BIA-ALCL, it is considered rare, particularly when one considers that the rate of breast cancer in the general population is 1 in 8 women.

Despite these very low rates of BIA-ALCL, it is important that women with breast implants do have regular breast checks, and be vigiilant to any changes that develop in their breasts.

The most common presentation of BIA-ALCL, is a swelling that develops around the implant, typically during the 7-10 year mark. However, if you develop a swelling associated with the breast at any point in time, or any other new change affecting the breast (s), it is important that you consult with your plastic surgeon to discuss such concerns.

The mechanism by which BIA-ALCL develops remains unclear, although it is thought that several factors may be at play. These factors include: implant surface texture, possible genetic predisposition, and the development of an inflammatory process around the implant. Research is ongoing, looking into a further understanding of BIA-ALCL development.

What are your options?

For women with textured implants who do not have any symptoms, it is not essential to remove the implants. Some women, who may not have any symptoms associated with their breast implants, may however chose to have their implants removed, simply knowing of the possible link to BIA-ALCL. There may be psychological benefits in proceeding along this path. For women who do have symptoms relating to implants, it is important that you consult with a surgeon to further assess your situation. Symptoms relating to breast implants include, pain, hardening, swelling, or a change in breast shape. Such symptoms may warrant further assessment with a breast scan and or require breast implant revision surgery. Please refer to our breast implant revision page for further information pertaining to this.