What is breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)?

Breast implant-associated anaplastic large cell lymphoma (abbreviated as BIA-ALCL) is a rare form of T-cell lymphoma that occurs in some people who have had breast implants. It is not breast cancer but rather is a cancer of the immune system. The disease may affect a very small number of women who have received breast implants, primarily of the textured (rough) type. The lymphoma occurs in the scar tissue (fibrous capsule) that surrounds the implant and in more advanced cases may spread to lymph nodes that are near the breast.

BIA-ALCL generally progresses slowly. Usually, it can be treated by surgically removing the breast implant or implants and scar tissue. However, in rare cases when cancer spreads to the lymph nodes in other parts of the body, it may be fatal.

How common is breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)?

BIA-ALCL is a very rare condition. Fewer than 10 patients each year are diagnosed with this form of lymphoma. It is estimated that 10 to 11 million women throughout the world have received breast implants. The vast majority of cases of the disease have occurred in patients who have received textured implants, according to information from the FDA. The risk of developing BIA-ALCL ranges from one in about 1,000 to one in 30,000 for people with textured breast implants.

What are the risk factors for breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)?

  • The exact cause of BIA-ALCL is not known, but risks seem to increase for implants with textured surfaces. It does not seem to matter if the implants are filled with silicone or saline.
  • Textured implants may cause more inflammation than smooth implants. Possible contributing factors include reactions to implant particles, long-term allergies, genetic factors, or reactions to bacteria that grow on the implant’s surface. There seems to be no difference in the risk of BIA-ALCL among women who receive implants for breast augmentation or for breast reconstructive surgery.

What are the symptoms of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)?

If you experience symptoms that concern you in the area of your breast implants, try to remember that non-cancer issues are a much more likely cause. It is recommended that women perform monthly self-examinations to check for lumps or other issues. All implant related symptoms should be evaluated by a board certified plastic surgeon.

In cases of BIA-ALCL, symptoms like changes in the size or shape of the breasts appear well after the surgical sites are healed. One breast may appear larger than the other, or look different in shape from the other (asymmetric). Usually, it takes at least two years after surgery for symptoms to emerge. However, the average length of time before symptoms appear is eight years.

Symptoms of BIA-ALCL may include:

  • Swelling or fluid accumulation in the breat or around an implant
  • Lumps
  • Pain
  • Changes in the shape or size of the breat or breasts
  • Redness

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