Update on Breast Implant Associated-Anaplastic Large Cell Lymphoma

  • Peak Rejuvenation   •   March 13, 2018

What is BIA-ALCL?  BIA-ALCL is a rare lymphoma noted to occur in patients with history of textured implants—and when caught early, it’s curable in most patients.  It is not a cancer of the breast itself.  All oncology organizations currently classify it as a lymphoma.  Ongoing research continues to better understand and define BIA-ALCL which consists of a spectrum of stages from a CD30+ seromas/effusions to capsular tumors to lymph node involvement and even distant metastasis.(1)


What are symptoms of BIA-ALCL?  BIA-ALCL usually develops as a delayed swelling of the breast (average eight years) after the insertion of textured breast implants, which may present as fluid collecting around the implant or marked breast asymmetry.  It can also present as a lump in the breast or armpit. (1)


What is risk of developing BIA-ALCL?  As of Jan 1, 2018, the PROFILE registry has received 186 unique cases of BIA-ALCL in the United States.  All cases were associated with a history of textured implants.  American Society of Plastic Surgeons reports that 300,000 breast augmentations and 150,000 breast reconstructions are performed annually, with approximately 10% of those receiving textured implants.  Worldwide, there have been approximately 500 unique cases reported.  (1) The FDA says the lifetime risk of developing BIA-ALCL in patients with textured implants is 1:3,817 to 1:30,000.(2). While the FDA has received 30 reports of cases that involved smooth-surface implants, no confirmed smooth surface-only cases have been logged into the PROFILE registry.(2)


Are all patients with breast implants at risk of developing BIA-ALCL? According to the ASPS task force, BIA-ALCL has only been confirmed in patients with a history of textured implants.(1)


What does the FDA recommend regarding implants.  Should healthy patients have their breast implants removed prophylactically?  The FDA stresses that no changes are needed in the routine medical care and follow-up, nor is there any need to test asymptomatic patients.(2) The FDA does not suggest prophylactic removal of breast implants for asymptomatic patients.(1)


How does Dr. Williams help to reduce risk of BIA-ALCL?  Since the task force was created by the ASPS, Dr. Williams has followed the issue of BIA-ALCL closely.  There are risks associated with all types of implants.  Since BIA-ALCL is predominantly associated with textured implants, Dr. Williams predominantly recommends smooth (non-textured) implants for both cosmetic and reconstructive breast surgery.(1)


Where can I find more information on BIA-ALCL?  www.plasticsurgery.org/alcl. (1)


(1) Plastic Surgery News, March 2018

(2) Plastic Surgery News, April/May 2018ind