The Australian Society of Plastic Surgeons recommend women with breast implants to monitor for any changes or swelling in their breasts and if it occurs to contact their doctor.

Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare cancer that can be effectively treated if detected early.

There may be some confusion in the community surrounding BIA-ALCL therefore we seek to clarify the known facts.

Facts associated with BIA-ALCL

  • It is a cancer of lymphatic cells and a form of Non-Hodgkin’s Lymphoma
  • It is not a breast cancer
  • It occurs in association with breast implants and to date exclusively with exposure to textured implants (ie. no case has been reported with exposure to smooth implants alone)
  • It occurs in women who have had implants for both cosmetic and reconstructive indications
  • It takes an average of 7-10 years after implant insertion before it develops
  • The commonest presentation is a fluid swelling around the breast implant and in the space between the implant and breast implant capsule. The diagnosis of the tumour is made by examination of the fluid
  • Early stage disease is curative with surgery alone
  • Disease which has spread through the capsule, forming a mass, or which has spread to local lymph glands carries a worse prognosis

Risk

An accurate study in Australia and New Zealand showed that the risk for implants with high surface area texture was around 10 times higher.

Recommendations

All patients undergoing breast implant surgery must be provided with informed consent that includes a discussion of risks of BIA-ALCL.

Implant selection should take into account what the patient already has, what the goals are, the patient’s lifestyle and the risks relative to various implant options.

Implant-specific risk should be discussed in the context of the overall benefits of a particular implant type and/or texture.

Routine implant removal is not indicated for asymptomatic women with breast implants including textured implants.

All women with implants who note changes in their breasts should seek advice. The overwhelming majority will not have BIA-ALCL.

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