Breast Implants – What you need to know

Recently there has been a lot of media coverage around a illness known as BIA- ALCL or Breast Implant Associated Anaplastic Large Cell Lymphoma.
As the name states this illness is associated with implants however it is not the implants themselves that are the cause. The most important things for women who have had, or are considering Breast Augmentation is to do adequate research, be aware of the symptoms and ensure to regularly see their Specialist Plastic Surgeon. 

If you are doing research on this subject we recommend you focus your attention on accredited organisations with accurate information. 
Both the TGA and the Australian Society of Plastic Surgeons are posting up to date, factual information on this topic. 

 

⚬ What Is It?

Breast implant associated cancer, which is also known as breast implant associated anaplastic large cell lymphoma (BIA-ALCL), is a rare cancer of the immune system. It is not breast cancer, which forms from cells in the breast, but instead a cancer that grows in the fluid and scar tissue that forms around a breast implant – it is not caused by the implant but linked to textured implants with scientists believing the textured surface allows for the bacteria to grow.

⚬ Will I Get It?

Breast implant associated cancer is rare. Between 1 in 1000 and 1 in 10,000 people with breast implants are diagnosed with the condition. Breast implant associated cancer can occur after both cosmetic and reconstruction surgery, with 95% of cases occurring between 3 and 14 years after the insertion of an implant. The risk for Australian women of breast cancer (not BIA-ALCL) is about 1:8. These are separate diseases.

⚬ What Causes It?

The unifying theory cites four inter-related factors;

  • Textured implants (with a higher risk for high surface area textures)
  • Bacterial contamination at the time of surgery to reach a threshold to cause inflammation
  • Patient genetic predisposition
  • Time for the process to develop

Bacteria have been identified in association with these tumours, similar to the association between gastric lymphoma and Helicobacter pylori.

Experts do not think breast implant associated cancer is related to either the contents (saline/silicone) or shape (round/teardrop) of the implant.

Due to one of the main theories of causation being contamination at time of implantation, it is very important to ensure that your surgeon carries out certain steps to combat bacteria growth. One easy way to check whether your surgeon will carry out the necessary steps is to see whether they have made a commitment to the 14 point plan.
Dr Briggs abides by all of these steps and has done since he first began as a surgeon. Many of these steps are apart of basic surgical training as a Specialist Plastic Surgeon. Patients of Dr Briggs can be assured that he has taken every step possible to prevent the risk of contamination during their surgery.

 

⚬ How Is It Treated?

In most cases, removal of the implants and the scar tissue that forms around the implant is all that is necessary to treat the cancer. If the cancer has spread to other areas of the body, further treatment is likely to be necessary, such as chemotherapy, radiotherapy or additional surgery. However, nearly all cases will show obvious symptoms before the cancer spreads.
The most common 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 seroma fluid.

⚬ How do I spot the symptoms?

It is important to know the symptoms of breast implant associated cancer. The most common symptom is swelling of a breast caused by fluid build-up, but in some cases it may appear as a lump in the breast or armpit.

As this is a rare disease, changes in your breast are unlikely to be breast implant associated cancer. For example, swelling immediately after your breast implant surgery is normal. But you should raise all concerns with your surgeon, including the possibility of breast implant associated cancer.

Breast implant associated cancer is not detected by a mammogram. If you develop swelling of an implanted breast, your doctor will send you for an ultrasound scan to see if the swelling is due to fluid build-up. If the ultrasound shows that fluid is present, a sample of the fluid will be removed and sent to a laboratory for analysis. This analysis will help identify if the fluid build-up is caused by breast implant associated cancer. Most fluid build-ups are not caused by breast implant associated cancer.

⚬ What if I have no symptoms at all?

Because breast implant associated cancer is rare, experts do not recommend removal of implants in a healthy person with no symptoms.