Breast implant associated anapestic large cell lymphoma (BIA-ALCL)
02.18.2020 | Category, Uncategorized
Since FDA’s announcement in 2019, there was a lot of confusion over breast implant associated anapestic large cell lymphoma (BIA-ALCL) but the initial panic appears to subsided now. Here are what we know about the condition.
- BIA-ALCL is a rare and treatable type of T-cell lymphoma that can develop around breast implants. It is not a cancer of the breast tissue itself.
- The lag time between current implant insertion to diagnosis of BIA-ALCL has been from 0.8-27 years, with an average of 9.75 years.
- No cases of BIA-ALCL have been reported with patients who have only had smooth implants in any case reports or registries.
- The association of BIA-ALCL and textured implants may be related to the increased surface area of the texturing; however, this has not yet been definitively proven. Interestingly, majority of BIA-ALCL have been with Allergan textured implants, which may be related to the proprietary method of texturing by Allergan.
- The disease has been associated with both silicone and saline implants in aesthetic as well as reconstructive patients.
- The majority of patients present as a delayed seroma or fluid collection around implant, but also present with symptoms of lump, skin rash, fever and night sweats and swollen glands. Diagnosis is based on the pathological examination of the fluid around the implant.
- The majority of patients can be cured of their disease by bilateral total capsulectomy and implant removal. Rare patients will present with a mass and have an increased risk of requiring radiotherapy and chemotherapy.
- The current FDA recommendation does not include prophylactic removal of the textured implants, but close observation.
The bottom line is it is such a rare condition, thus close observation is recommended at this time. In addition, majority of my patients have Mentor smooth implants, and thus they are at a lesser risk of developing the disease.
If you haver any further questions or concerns, please do not hesitate to contact us.