In recent years, there have been a rising number of anecdotal reports of breast implants being linked to health problems, including BIA-ALCL, a rare type of cancer.
There have been 30 recognized cases of BIA-ALCL in Canada. According to the U.S. Food and Drug Administration (FDA), there have been approximately 780 cases of BIA-ALCL worldwide. The good news is that BIA-ALCL is very treatable.
What is BIA-ALCL?
BIA-ALCL stands for breast implant-associated anaplastic large cell lymphoma. It is a type of Non-Hodgkin lymphoma that develops following the placement of breast implants. BIA-ALCL is not breast cancer, but rather a cancer of the lymphocytes, a type of white blood cell. Patients with BIA-ALCL often develop a seroma, or collection of fluid, around the breast implant. BIA-ALCL occurs when anaplastic large cell lymphoma cells grow on the inside of the capsule that forms around the breast implant.
Who Is At Risk?
As of now, cases of BIA-ALCL have been linked only to women with textured breast implants. Both silicone gel and saline implants have been reported in cases of the cancer. The time between implant insertion and diagnosis of BIA-ALCL is between one month and 27 years, with the average being a little over nine years.
The vast majority of cases of BIA-ALCL in Canada have been linked to macro-textured implants. As a result, Health Canada and the FDA have enforced a recall of all Allergan Biocell macro-textured breast implants.
Signs of BIA-ALCL
For many patients, the first sign of BIA-ALCL is delayed seroma, meaning seroma not related to the breast augmentation surgery itself. Other signs include a mass or masses developing on the breast, sudden change in breast size, skin rash, fever, night sweats and lymphadenopathy (swollen lymph nodes). There are a number of tests that can be performed to determine whether these symptoms are actually BIA-ALCL.
How BIA-ALCL Is Treated
Like other types of lymphoma, BIA-ALCL is very treatable.
If the cancer is limited to the area around the implant, the implant itself and the surrounding capsular tissue are removed. This surgery is covered under the B.C. Medical Services Plan. Any associated lumps or masses are removed. Radiation therapy and chemotherapy may be needed if the cancer has metastasized.
Removing Your Breast Implants
No governing bodies, including Health Canada and the B.C. Health Plan, have approved the removal of breast implants in the absence of clinical evidence of BIA-ALCL. In these cases, the removal of breast implants is not covered by medical insurance. This may be changing, however. In British Columbia, a serious discussion has begun about providing coverage for removal of asymptomatic textured implants (on a case by case basis) if both patient and physician feel it is the right thing to do.
For now, if you have Allergan Biocell breast implants and want to remove them due to concern of BIA-ALCL, Allergan will provide two free implants with smooth shells. (Smooth shell breast implants have not been linked to any cases of BIA-ALCL.) Or, you may choose to remove the breast implants and replace them with nothing. In this case, our team can discuss with you your options for breast reconstruction.
If you have questions or concerns regarding BIA-ALCL, contact The Plastic Surgery Group at City Centre today.