Rare Cancer Linked to Breast Implants Draws Attention

The New York Times recently reported that anaplastic large-cell lymphoma or ALCL, a rare cancer that starts in the cells of the body’s immune system, is linked to the use of breast implants. In March the FDA announced the disease has caused nine deaths worldwide. It was first identified by the FDA in 2011 and information about it was added to breast implant labels.

Background

While more than 10 million women worldwide have breast implants for a variety of reasons, the American Society of Plastic Surgeons says about 110,000 women get implants after breast cancer every year in the U.S.

There are different shapes, sizes, textures and materials of implants for people to choose. What they are made of, how they are shaped, and what kind of surface they have can help them look and feel more natural.

Most implants used in the U.S. are smooth, round and can move without affecting the way the breast looks. But another less common option is textured implants, which have a rough surface that nearby breast tissue can grow into. Unlike smooth implants, textured implants are shaped more like real breasts and would look strange if they moved. The textured surface keeps them from moving.

Since first identifying the disease and its link to implants, the FDA has received fewer than 400 reports of the condition worldwide. But since many doctors hadn’t even heard of it until now, the number of reported cases is expected to rise. Women have been diagnosed with the cancer as early as 2 years and as late as 28 years after getting implants.

Many things about this condition are still unknown. Experts don’t know why it’s so much more common with textured implants than smooth implants. According to the New York Times, some think bacteria get into the implant’s grooves and cause infection and inflammation, or that the texture itself causes inflammation of the tissues around it. It is also unknown if a person’s age, race or other factors affect their risk of anaplastic large-cell lymphoma.

It doesn’t appear to matter if the implant is made with saline or silicone, two common materials used in implants, or if the implants were used in people who chose to have implants without a medical reason or in people with breast cancer.

Diagnosis and Treatment

Anaplastic large-cell lymphoma can cause pain, swelling, nipple discharge and lumps in the breast. It can be found when women experiencing those symptoms go to the doctor. It may also be found if a woman’s implants are being replaced. To diagnose the disease, doctors test fluid around the breast for the substance CD30, which suggests lymphoma.

The National Comprehensive Cancer Network recently issued treatment guidelines for the lymphoma. They recommend removing the implant and scar tissue forming around it. According to the New York Times, “the disease is usually treatable and not often fatal. Removing the implant and the entire capsule of scar tissue around it often eliminates the lymphoma. But if the cancer has spread, women need chemotherapy and sometimes radiation.”

What This Means for You

It’s very upsetting to think that breast reconstruction you had as part of your recovery from breast cancer could lead to another type of cancer. But remember, this cancer is

• extremely rare
• much more strongly associated with implants that are textured, not smooth
• very treatable when caught early

The FDA says women with breast implants do not need to change their routine medical care and follow-up practices. It does not recommend removing breast implants if you have no symptoms.

If you do experience pain, swelling, nipple discharge or breast lumps, or any other unusual change in your breast, you should see your doctor immediately. He or she will be able to tell you if what you are experiencing is from current or past breast cancer, implant-related lymphoma, or something else.

If you feel your symptoms aren’t being taken seriously, don’t hesitate to find a new doctor. It may be hard to find a doctor with experience treating anaplastic large-cell lymphoma, but it’s not impossible. For example, according to the New York Times, “doctors at MD Anderson have treated 38 cases and have a laboratory dedicated to studying the disease.”

If you haven’t had breast reconstruction but are considering it, check out LBBC’s information on breast reconstruction and talk to your doctor about the pros and cons of different types of reconstruction and how to minimize your risk of this and other secondary cancers.