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Update on BI-ALCL; Breast Implant Associated Lymphoma

By Dr. Sutton Graham on April 16, 2018


Plastic surgery national organizations have been working closely with the Food and Drug Administartion in the US and similar investigations are going on worldwide to better understand a recently discovered tumor arising near breast implants.  (See an earlier blog below.)  The tumor is not breast cancer, but rather a specific type of lymphoma, which are more commonly a type of blood tumor.  The name is Breast Implant Associated Anaplastic Large Cell Lymphoma or BI-ALCL.

The FDA notes approximately 400 identified cases and 9 deaths.  The estimated lifetime risk is between 1:3800 and 1:30,000 women with implants.  Recent research appears to indicate that all cases are associated with texture surface implants, either past or current use.  It has effected both cosmetic breast augmentation and post-mastectomy reconstruction patients.  The causes are unknown, but research is on-going.

Textured surface implants remain in common usage, often for particular indications including prevention of rotation by shaped implants or reduction of capsular contracture.  Dr. Graham has used such implants for breast reconstruction and augmentation, although almost all of our current implants are smooth surface, saline filled implants.

Patients who developed this condition usually noticed recent one sided swelling or asymmetry.  Diagnosis is begun by ultrasound examination and removal of fluid for evaluation.

More information is available from the FDA website:

https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239995.htm

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