BIA-ALCL is a type of cancer caused by textured breast implants. Early detection is important. Complete surgical removal of the implant and the surrounding capsule can cure BIA-ALCL. If the cancer spreads, you may need radiation therapy or chemotherapy.
Breast implant-associated anaplastic large cell lymphoma is also called BIA-ALCL. It’s a rare form of lymphoma that occurs in some people who’ve had breast implants. It’s a type of immune system cancer and isn’t breast cancer.
This type of lymphoma occurs in the fluid and scar tissue (fibrous capsule) around the implant. In more advanced cases, it may spread to lymph nodes near your breast and in other parts of your body. It can also enter your chest wall underneath your breast.
BIA-ALCL generally grows slowly. Usually, healthcare providers treat it surgically by removing the breast implant and surrounding capsule. In rare cases, it can be fatal.
The Food and Drug Administration (FDA) tracks global cases of BIA-ALCL. As of January 5, 2020, there were 733 known cases and 36 deaths ever reported. This translates to a very small risk for the millions of people who’ve received breast implants.
BIA-ALCL affects a very small number of people who’ve received textured (rough) breast implants. In the past, the rough texture of these implants was chosen to help breast implants stay in place.
Smooth breast implants aren’t as commonly associated with BIA-ALCL. However, research is still underway to confirm this.
The type of material inside of a breast implant (silicone vs. saline) doesn’t appear to play a role in this disease. Implants are usually made of silicone or saline. Both smooth and textured implants can be made from either material. BIA-ALCL has occurred in people with silicone and saline implants.
The FDA also reports that approximately 85% of BIA-ALCL cases have been in people who received BIOCELL® textured implants from Allergan. Because of this, Allergan has discontinued providing these implants and asked surgeons and hospitals to return any remaining stocks.
BIOCELL textured tissue expanders were also included in the “recall.” Tissue expanders are balloon-like devices healthcare providers implant after a mastectomy. They inflate slowly over time and help stretch your breast skin and tissue before you receive a permanent breast implant. It isn’t clear if tissue expanders increase the risk of BIA-ALCL.
If you have BIOCELL breast implants from Allergan, the FDA doesn’t recommend removing them. They advise you to:
Alternatively, you can always elect to have your breast implants removed or exchanged.
The most common symptoms include changes in the size or shape of your breasts. Usually, one breast will appear larger than the other or look different in shape.
Symptoms can appear as early as one year after you receive the implant or many years later. On average, symptoms start eight years after implant surgery.
The symptoms of BIA-ALCL include:
If you experience symptoms that concern you, remember that noncancerous issues are a much more likely cause. These may include:
Healthcare providers aren’t sure why people with textured breast implants sometimes develop BIA-ALCL. One possible cause is a chronic infection around the implant that stimulates your immune system. Over time, this can lead to cancer of your immune cells.
Scientists think there may also be a genetic component to BIA-ALCL. This means that some people may be more susceptible to this type of cancer.
Your healthcare provider will review your medical history and ask you about your symptoms. They’ll also perform a physical examination.
If your provider suspects you might have BIA-ALCL, they may schedule diagnostic tests. These may include:
If your healthcare provider makes a diagnosis of BIA-ALCL, they’ll refer you to a cancer specialist (oncologist). You’ll see your oncologist for further evaluation and treatment planning. Part of this evaluation may include a PET scan to find out if the cancer has spread.
The main treatment is breast implant removal. Your plastic surgeon can remove the implant, the surrounding fibrous capsule and any masses.
Surgery may be the only treatment you need. This is more likely if you have an early stage of the disease and the surgeon is able to remove the entire capsule.
The risk of the cancer returning is higher with incomplete removal of the capsule. If this happens, or if the cancer has spread, you may need other types of treatment. When planning your treatment, your healthcare provider will consider your:
Your treatment may include:
If you don’t receive radiation therapy or chemotherapy, you may be asked to see your provider on a routine basis — perhaps every three to six months for a couple of years. Your visits may include PET/CT scans every six to 12 months to check for signs of recurrence.
Follow-up care after radiation therapy or chemotherapy will depend on your progress. Your healthcare provider will monitor you closely to provide appropriate follow-up care.
You can’t prevent this disease, but early detection can improve your outcome. Monthly breast self-exams and annual checkups can help you identify lumps or other issues before they spread. Let your healthcare provider know if you notice any swelling, lumps, breast pain or changes in breast appearance.
While routine mammograms are important in detecting breast cancer, they won’t detect this type of lymphoma.
If you’re planning cosmetic or reconstructive breast surgery, let your surgeon know if you have any safety concerns. Your surgeon will help you make an informed decision about what type of surgery or implants are right for you. You may also want to review guidance from the FDA before getting breast implants.
The prognosis for BIA-ALCL is better with:
For the majority of people with BIA-ALCL, the cancer remains confined to the fibrous capsule. This leads to a better outlook. In 3% to 5% of patients, the cancer spreads beyond the capsule.
One study of 87 people who were diagnosed with BIA-ALCL found that 91% were alive five years after treatment.
If you have breast implants, talk to your healthcare provider right away if you notice any changes in your breasts.
A note from Cleveland Clinic
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a very rare condition that occurs in people who have textured breast implants. Most cases of BIA-ALCL have been associated with BIOCELL implants made by Allergan. If you have breast implants, make sure you know what type yours are. You can contact your surgeon or surgical facility to find out.
Although the FDA recalled BIOCELL implants, they don’t recommend removing them. If you have these implants or another brand of textured implants, monitor your breasts for swelling or lumps through monthly self-exams. Schedule an appointment with your healthcare provider right away if you notice any changes in your breasts. Early detection and complete surgical removal of the implant and surrounding capsule can cure this condition. It can also prevent the need for additional treatment, such as radiation therapy and chemotherapy.
Last reviewed by a Cleveland Clinic medical professional on 06/28/2022.
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