Since our previous article regarding the connection between textured breast implants and Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), additional information on understanding the disease and its treatment has surfaced.
Background on BIA-ALCL and Recent Legislation
While the cause of BIA-ALCL was initially believed to be from a biofilm on the implant, current research is unclear how big of a role it plays in the disease. Specific textured devices, such as the Allergan Biocell textured implants, have a much higher association with BIA-ALCL. You can refer to our article on the topic, “U.S. FDA Refrains from Textured Implants Ban“, for more information on textured breast implants.
Current Treatment Options
In a May 2020 OncLive article, “Breast Implant-Associated ALCL Understanding and Treatment Evolves“, Dr. Lloyd B. Gayle addressed the current treatment options as well as what the future holds for BIA-ALCL patients. Dr. Gayle is the director of Plastic Surgery Resident Education and associate professor of clinical surgery at Weill Cornell Medical College:
Breast implant–associated ALCL is a relatively new entity, so treatment modalities are evolving. The cornerstone to this is understanding that with early diagnosis, specifically in patients with stage I/II disease where there is no spread beyond the breast, the capsule, and the surrounding soft tissue, treatment is best rendered with a total capsulectomy. [Total capsulectomy] is now defined as an unblocked resection, which is to say the removal of the implant, the surrounding capsule, and any surrounding mass within the soft tissue.
As the understanding we have of the disease grows, treatment for BIA-ALCL is becoming more interdisciplinary. Currently, radiation therapy and chemotherapy are used in combination with a total capsulectomy. Many patients also see several doctors, who work collaboratively to administer treatment.
What the Future Holds
Moving forward, it is important to keep up-to-date on BIA-ALCL information as more research is being done. In the recent OncLive article, Dr. Lloyd B. Gayle highlights the current treatment recommendations:
Textured devices from Allergen have been voluntarily removed from the marketplace. The current recommendation is to not preemptively remove these devices from patients unless they present with symptoms, or unless they have other drivers such as capsular contracture, aesthetic concerns, or implant rupture. In those cases, you should proceed with implant removal.
Dr. Gayle also addresses the growing concerns surrounding the lack of research currently done on BIA-ALCL cases:
Is the previous presence of a textured tissue expander still a significant risk, or is it only the implant that is at hand? Almost all cases have had some prior experience with or exposure to a textured device. There is still so much that we don’t know in terms of the diagnostic workup and which patients are at risk.
Dr. Gayle also recommends patients who may be at-risk for BIA-ALCL keep themselves educated on the disease. Medical providers and breast implant manufacturers, such as Allergen, should also make patients with textured devices aware of their potential risk.
As always, we will continue to monitor the worldwide issues surrounding breast implants and BIA-ALCL, and provide you with any new or relevant information.
Written by: Lauren Schwab, Legal Assistant
Law Offices of Thomas J. Lamb, P.A.