ALCL - Facts that Breast Augmentation Patients Need to Know

Anaplastic large cell lymphoma (ALCL) has been identified as occurring in a small number of patients with breast implants.

ALCL is a rare type of non-Hodgkin's lymphoma and is not a cancer of breast tissue. The US FDA is investigating this possible association and "believes that there is a low but increased risk of developing ALCL adjacent to the breast implant".

Approximately 60 cases have been identified throughout the world, which represents a fraction of the 5-10 million women who have received breast implants. It is estimated that the risk of ALCL for breast augmentation patients is between 1 in 250,000 and 1 in 1 million.

Breast implants have been proven not to increase the risk of breast cancer; breast cancer can affect up to 1 in 7 women in developed countries. There is no association between ALCL and any particular breast implant brand, shell or whether the implant has saline or silicone fill. Of the known cases of ALCL in patients with breast implants there are some warning signs that patients should be aware of. If a breast lump is detected or if one of the breasts becomes larger or tighter than the other then it is recommended that breast augmentation patients are reviewed by a Plastic Surgeon.

An MRI scan may be ordered to assess the implant integrity and adjacent breast tissue for any abnormal lumps. If a seroma (a fluid collection around the implant) is suspected then an ultrasound scan can be used for documentation or used to aspirate any seroma fluid which can then be sent to the laboratory to test for the presence of ALCL cells.

If  ALCL is suspected or confirmed with these investigations then implant removal with capsulectomy is recommended. The breast capsule is then sent to the laboratory for further testing. There is, however, a slightly silver lining to this warning - ALCL developing around breast implants is a clinically indolent disease with a favorable prognosis that is quite distinct and different from systemic anaplastic lymphoma kinase-negative ALCL.

Although some women underwent irradiation and/or chemotherapy after breast implant removal and capsulectomy for ALCL, more recent reports suggest that outcome and survival may be equivalent with only implant and implant capsule removal. Prospective breast augmentation patients need to be aware of ALCL and discuss this with their Plastic Surgeon, patients need to be reassured that the risk is of developing ALCL is extremely low and that ALCL behaves in an indolent manner.

If you have any specific requests regarding cosmetic surgery topics that you would like discussed on this blog, please feel free to email me: chris@breast-body.co.nz