Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare cancer of the immune system. BIA-ALCL has been closely linked with textured surface breast implants.
What Causes BIA-ALCL?
While BIA-ALCL is rare, it is very serious and potentially fatal if not treated properly. According to this December 2020 article, “Etiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL): Current Directions in Research“, the U.S. currently has a lifetime risk of about 1 per 30,000 women with textured implants. The article gives several proposed triggers for the disease:
Proposed triggers for the development of malignancy include mechanical friction, silicone implant shell particulates, silicone leachables, and bacteria. Of these, the bacterial hypothesis has received significant attention, supported by a plausible biologic model.
The bacterial hypothesis is currently the most accepted and developed hypothesis for the cause of BIA-ALCL. In short, essentially a biofilm containing harmful bacteria forms on top of the implant, eliciting an inflammatory immune response. As a result, this causes a malignant transformation of cells resulting in BIA-ALCL.
Implant Removal Case Studies
A study of 18 cases that involved implant removal and capsulectomy at the Memorial Sloan Kettering Cancer Center examined the relationship between breast implants and BIA-ALCL. Out of the 18 cases, 16 received the implants for reconstructive purposes after breast cancer. Additionally, two individuals received breast implants for cosmetic reasons.
According to this November 2020 article, “Clinical Characteristics and Follow-up Post-Surgery of Women with BIA-ALCL Operated at a Single Institution“, the breast implants varied in characteristics, although treatment remained the same for all women:
18/18 (100%) silicone surface, 17/18 (94%) had a biocell textured surface, 1/18 (6%) unknown surface, 9/18 (50%) silicone filled, and 9/18 (50%) saline filled.
BIA-ALCL presented as effusion in 14/18 (78%) of cases, mass in 3/18 (17%) of cases, and PET+ intramammary lymphadenopathy in 1/18 (6%). Pre-surgery, cases were assessed with PET/CT in 15/18 (83%), US in 15/18 (83%) and MR in 7/18 (39%).
Initial treatment was implant removal and capsulectomy for all women, with removal of all the implants in place.
Furthermore, out of these patients, the overall survival rate was 94% at two years. Overall progression-free survival was at 89% for two years. The data seemed to support the importance of adequate surgery in treating patients with BIA-ALCL or other seroma-confined diseases.
As always, we will continue to monitor the worldwide issues surrounding breast implants and BIA-ALCL. We will provide you with any new or relevant information.
We encourage you to visit our Breast Implants Lymphoma Cancer page on our website for more information. Please submit a free case evaluation if you or someone you know has been diagnosed with BIA-ALCL.
Written by: Lauren Schwab, Legal Assistant
Law Offices of Thomas J. Lamb, P.A.