by Dr. C.H. Weaver M.D. updated 12/2022
Anaplastic large-cell lymphoma is a rare cancer accounting for 3% of breast lymphomas and thought to be a potential adverse effect of breast implants. Anaplastic large-cell lymphoma was first described in 1997 and the FDA issued a safety communication cautioning about a possible association between breast implants and anaplastic large-cell lymphoma in 2011.
The number of lymphoma cases linked to breast implants increased in the second half of 2019, according to the FDA. The agency identified 733 unique cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) worldwide. Almost 85% of confirmed BIA-ALCL cases reported to the FDA involved implants made by Allergan. In response to a request from the FDA, Allergan recalled specific models of its textured implants due to a potential risk for BIA-ALC an, the FDA issued draft guidance recommending inclusion of a boxed warning on breast implant labeling to ensure women receive and understand complete information about their benefits and potential risks.
Incidence of ALCL Rising rapidly in US
Age-adjusted incidence of anaplastic large-cell lymphoma of the breast increased in the U.S. between 2000 and 2018 according to an analysis of the SEER database published in JAMA Oncology.
Results from a 2022 analyses showed an age-adjusted incidence rate of primary breast anaplastic large-cell lymphoma of 8.1 per 100 million persons per year, for a cumulative lifetime risk of 7.5 per 100 million persons at age 79 years.
Moreover, researchers identified an estimated 353 cases of breast anaplastic large-cell lymphoma diagnosed through 2017 in the SEER database and 310 cases in SEER/National Program of Cancer Registries data, compared with 333 cases reported to the FDA during a similar time period.
About BIA-ALCL
Over time, a fibrous scar called a capsule develops around an implant which separates it from the rest of the breast. In patients with breast implants the lymphoma is generally found adjacent to the implant itself and contained within the fibrous capsule.
Symptoms of the anaplastic lymphoma typically include swelling and redness around the breast implants. The average time between implantation and the development of the lymphoma is 9.2 years.
About 10 million to 11 million women in the world have breast implants, according to the American Society of Plastic Surgeons and the Plastic Surgeon Foundation so the condition is quite rare but needs to be looked for and detected early.
According to the FDA most of the lymphomas occurred in people who had textured surfaces on their implants, rather than smooth surfaces. The illness is slow-growing and treatable when it’s detected early. Routine breast screening however is probably the best way to monitor for the changes with mammograms or MRIs.
People who are considering getting implants should do their research and discuss with their surgeons the risks and benefits of textured- and smooth-surfaced implants, the FDA has warned in the past.
Reference:
FDA reports additional cases of cancer linked to breast implants
