If you have textured breast implants, you may have heard about a rare condition called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). It can be concerning to find out about this condition.
It’s important to know that:
- BIA-ALCL is uncommon
- It is a different type of cancer than breast cancer
- Most people with breast implants will never develop it
Snehankita Calarese, MD, a plastic surgeon with Banner MD Anderson Cancer Center, explained what BIA-ALCL is, who may be at higher risk and when to talk with a health care provider.
What is BIA-ALCL?
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is not breast cancer. It is a rare type of non-Hodgkin’s lymphoma. Lymphoma is a cancer of the immune system.
If BIA-ALCL occurs, it’s usually in the scar around the implant or in fluid that collects near the implant. It is most strongly linked with textured surface breast implants. Whether those implants are filled with saline or silicone doesn’t seem to affect your risk.
“It’s not clear how these implants cause BIA-ALCL,” Dr. Calarese said. Researchers continue to study why textured implants may increase risk.
It’s possible that the rough, sandpaper-like surface of textured breast implants might cause inflammation that leads to BIA-ALCL. Or the larger surface area of a textured implant traps more bacteria and that could be what causes inflammation and BIA-ALCL.
What increases the risk of developing BIA-ALCL?
The primary risk factor is having textured surface breast implants. You may have had these implants placed for breast reconstruction or for cosmetic breast enhancement.
Not all textured breast implants carry the same level of risk but textured surfaces have been linked to most cases. The U.S. Food and Drug Administration (FDA) recalled some textured implants, including those made by Allergan Biocell, after reports of BIA-ALCL.
Your risk of developing BIA-ALCL increases the longer you’ve had textured implants in place. It’s often diagnosed years after surgery. “However, keep in mind that the risk of developing BIA-ALCL is still low,” Dr. Calarese said.
How common is BIA-ALCL?
BIA-ALCL is considered rare. The FDA and professional organizations track reported cases through systems such as the PROFILE registry, which help gather data that can uncover risk patterns. Cases have been found worldwide but the likelihood of developing BIA-ALCL is very low compared to the number of textured implants placed.
What symptoms should you watch for?
“Symptoms of BIA-ALCL typically happen years after breast implant surgery,” Dr. Calarese said. Common signs include:
- Breast swelling
- Fluid buildup around the implant
- A lump near the implant or in the breast
- Redness or skin changes
- Breast pain
Less-common symptoms include:
- Enlarged lymph nodes
- Rash
- Fever
- Weight loss
If you notice swelling, changes around your implant or other symptoms, it does not mean you have BIA-ALCL. But it’s important to contact your health care provider.
How is BIA-ALCL diagnosed?
Your provider may order imaging such as an ultrasound or MRI to see if fluid is collecting around the implant or to evaluate masses. Fluid can be tested for BIA-ALCL cells. Your provider may refer you to a specialist who is experienced in diagnosing and treating this condition.
How is BIA-ALCL treated?
Treatment typically involves surgery to remove the implant and the scar tissue around it. “Even if one implant is affected, both implants should be removed,” Dr. Calarese said. In some cases, your care team may recommend other therapies, like chemotherapy, radiation therapy or stem cell transplant therapy, depending on the stage of the disease.
“For people who receive appropriate, timely treatment, the prognosis is very good,” Dr. Calarese said.
What if you have textured implants but no symptoms?
The FDA does not recommend removing textured breast implants if you do not have symptoms. “The risk of developing BIA-ALCL is rare, but you should monitor your breasts with regular examinations,” Dr. Calarese said.
It’s important to:
- Know the type of implant you have
- Perform routine breast self-exams
- Report any changes or symptoms to your health care provider
- Continue regular medical follow-up
If you aren’t sure whether your implants have a textured surface, check with your plastic surgeon or your medical records.
Take a proactive approach to implant health
If you have breast implants, paying attention to your breast health and communicating with your health care team are key.
If you notice changes such as swelling, fluid or a new lump, schedule an appointment. Most of the time, implant-related changes are not related to BIA-ALCL, but getting checked is important.
The bottom line
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is rare and mainly linked to textured surface breast implants.
However, most people with textured implants will not develop BIA-ALCL. It’s important to stay informed, watch for changes and connect with your health care provider if you have any concerns. That way, your care team can help you decide on the next steps.
If you want to know more about your breast health, BIA-ALCL and other implant-related conditions, reach out to a Banner Health provider.
