BIA-ALCL is found in the scar tissue, also known as a capsule, surrounding the breast implant. The body creates this scar tissue naturally.
In few patients with textured implants, BIA-ALCL may form within the capsule and affect the lymph nodes. Further research is necessary to determine the exact cause of BIA-ALCL, but possible causes include textured implant particles, allergies over time, and a reaction to bacteria residing on the surface of the implant.
Symptoms of BIA-ALCL include swelling in the affected breast developing over a short period of time like days to weeks.
Currently, is believed that the risk of developing BIA-ALCL ranges from 1:1000 to 1:30,000 only in patients with textured implants. There have been 595 recorded cases of BIA-ALCL around the world as of September 2018. 16 of these cases were fatal.
It is important to note that BIA-ALCL is not considered a risk in patients with smooth implants.
What the FDA and Health Canada say
Health Canada and the FDA have stated that BIA-ALCL is an uncommon risk and curable. Most patients with BIA-ALCL must have surgery.
If a patient does not experience any symptoms despite having textured breast implants, there is no need to remove or replace their implants. They should continue to have routine followups as normal, as outlined by the FDA and Health Canada. This includes the following:
- regular checkups by their doctor
- magnetic resonance imaging (MRI) three years after their surgery, and then every two years after that — MRI is effective in detecting silicone implant ruptures.
- regular monthly self exams
If a patient does develop changes or symptoms, they should contact their doctor as soon as possible.
Diagnosis and Treatment
The diagnosis of BIA-ALCL is based on the National Comprehensive Cancer Network (NCCN) guidelines. Breast imaging is recommended to detect fluid, a mass, or lymph node swelling.
The current treatment recommended is to remove the breast implant in its entirety, along with any related lumps or masses. One or both breasts may be affected.
To date, removal of the affected scar tissue around the breast implant has cured most patients. If surgical removal is unable to eliminate the disease from the body, medications may be prescribed.
A note about textured breast implants
When properly used, all breast implants are considered safe by the FDA and Health Canada. We'll talk to you about your options before surgery, along with all the risks involved. This allows you to make an informed decision about your surgery.
Do you have textured implants?
Allergan, the manufacturer of the textured implants known as BIOCELL®, have announced that they will pay for new smooth implants for patients who wish to have explanation of their textured implants.
For more information regarding BIA-ALCL, please contact us.