Breast Implant Associated Anaplastic Large Cell Lymphoma
BIA-ALCL stands for Breast Implant Associated Anaplastic Large Cell Lymphoma.
It is a rare lymhoproliferative disorder that is associated with breast implants. Very rarely, it may lead to a type of cancer of the capsule that surrounds the implant. It is not technically “breast cancer”.
BIA-ALCL symptoms include swelling of the breast due to an accumulation of fluid, or more rarely presents as a swelling or lump, and typically appears between 3 to 14 years after surgery. 50% of cases occur by 7 to 8 years after implantation. This swelling is due to an accumulation of fluid. Less commonly, BIA-ALCL can take the form of a lump in the breast or lump in the armpit.
Currently the worst case estimate of the risk for the implants affected by the proposed suspended/cancelled implant types remains very low, about 1 in 1000. This means 99.9% of women with these implants will not get BIA-ALCL.
For the 1 in 1000 patient who does develop BIA-ALCL there is 8-9 out of 10 chance they have a version of the disease that is confined to the fluid around the implant. This is 100% cured by removal of implants and the capsule (membrane) surrounding them.
This leaves one or two women in 10,000 who have a cancer beyond the fluid. In most of these, the cancer cells are localised in the capsule. These patients are also cured by the removal surgery and do not need any other treatment.
The risk of developing an invasive cancer that needs chemotherapy and/or radiotherapy in addition to surgery is less than 1/10,000 and when this is needed, it is usually curative. The risk of dying from BIA-ALCL does exist but is so small it cannot be reliably calculated. It is considered to be less than 1 in 1 million.
To put this in perspective, the risk for any Australian woman, with or without implants, of developing breast cancer in her lifetime is 1 in 8. The lifetime risk of developing lymphoma is 1 in 50.
Whilst this is encouraging, it is essential that all women who are diagnosed with BIA-ALCL have the surgical treatment that is known to be curative.
If you are not experiencing swelling or lumps in your breasts then the advice is to do nothing, except continue to monitor and perform regular checks on your breasts. There is no need to get your implants removed as a precaution. Mammograms should be performed as usual. If you are experiencing swelling or changes to your breasts, you should contact your GP or your breast implant surgeon.
More information on BIA-ALCL can be found from the TGP website, which is updated on a regular basis.