Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Australian Society of Plastic Surgeons FAQs on ALCL 191216 FAQs on ALCL 191216_2

The Therapeutic Goods Administration (TGA) has recently updated the public information on its website about breast implant associated anaplastic large cell lymphoma in consultation with other international regulatory agencies, scientific experts including plastic surgeons, breast surgeons, haematologists, and epidemiologists as well as breast implant manufacturers.

We have known about this disease for quite some time and the TGA has been providing updates since 2011. This most recent update gives a more completed picture of our current understanding of this disease.

1. BIA-ALCL is a rare form of lymphoma that develops adjacent to breast implants

  • Because it is rare it is difficult to be certain about the absolute risk
  • It may be 1 in 5000 women with breast implants

2. BIA-ALCL is not breast cancer

  • The risk of developing breast cancer is about 1 in 8 women

3. What are the symptoms of BIA-ALCL in women with breast implants?

  • The most common symptom is the persistent swelling of the breast
  • Can include other symptoms such as a lump in the breast or armpit
  • These symptoms develop between 3 and 14 years following the insertion of the breast implants and most commonly around 8 years
  • The swelling of the breast is due to the fluid accumulating around the implant

4. Are all implant types associated with BIA-ALCL?

  • ALCL has not been identified in women who have only had smooth implants
  • Because this disease is rare we cannot be certain if different types of textured and polyurethane implants have a greater risk than others.

5. How is BIA-ALCL diagnosed?

  • In patients with fluid collection around the implants an ultrasound should be performed to exclude the diagnosis
  • At the time of ultrasound examination, a needle is inserted to drain some fluid which is then tested

6. How is BIA-ALCL treated?

  • Most women who are diagnosed with this disease are treated by the removal of both implants and the fibrous capsule around them and this is complete treatment
  • In a small number of women, the disease is more advanced and treatment may involve chemotherapy and radiotherapy

7. Can breast implants be inserted again if I have BIA-ALCL?

  • Current treatment protocols indicated that both implants should be removed as there are a small number if women who have has this disease on both sides at the same time
  • Implants should not be replaced at the time of the initial treatment
  • In a small number of women smooth implants have been returned after 12 months without signs of disease progression but the safety of this is sill being investigated

8. Where can I get more information?

  • The TGA has recently provided quite a comprehensive updated of its public information and this is available on its website under the section alerts
  • https://www.tga.gov.au/alert/breast-implants
  • If you need more information and particularly  more specific information please feel free to contact us, and you should obtain a referral to see your Plastic Surgeon

Posted: January 18th, 2017

Posted In: TGA Alerts

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