What is ALCL? (Anaplastic large cell lymphoma)

The press have recently published several articles regarding a connection in women with breast implants being at greater risk of developing cancer so we wanted to take this opportunity to talk a little bit more about the findings and our advice to patients who have breast implants or are considering breast implant surgery.

What is ALCL

Anaplastic large cell lymphoma (ALCL) is a rare type of non-Hodgkin lymphoma (NHL). Like all lymphomas, it is a cancer of the lymphatic system – part of the body’s immune system.

In 2011 the FDA (Food and Drug Administration) identified a possible association between Breast Implants and the development of ALCL. At that time they were aware of 60 cases of the 5-10 million who have had breast implant surgery, which included 34 unique cases reported between 1997 and 2010.

Since 2011 the FDA have strengthened their understanding of the condition and agree with the World Health Organization designation of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) as a rare T-cell lymphoma that can develop following breast implants. At this time, most data suggest that BIA-ALCL occurs more frequently following implantation of breast implants with textured surfaces rather than those with smooth surfaces.

As of February 1, 2017, the FDA has received a total of 359 medical device reports (MDRs) of BIA-ALCL, including nine deaths. There are 231 reports that included information on the implant surface. Of these, 203 were reported to be textured implants and 28 reported to be smooth implants. Most of the reports contained no information about the surface textures of any previous implants. In addition, 312 of the 359 reports included information on implant fill types. Of these, 186 reported implants filled with silicone gel and 126 reported implants filled with saline.

It is important to note that details on breast implant surface and fill type are limited however there appears of be a connection found more frequently with textured implants. While the MDR system is a valuable source of information, it may contain incomplete, inaccurate, untimely, unverified, or biased data.

Anaplastic large cell lymphoma ALCL is rare

It is also important to put this data into perspective, ALCL is rare. According to data collected by BAAPS in 2015, Breast Augmentation was the most popular procedure carried out in the UK with over 9,000 women per year electing to undergo Breast Enlargement, so these occurrences in comparison are very small.

As an existing patient with breast implants, should I be worried?

If you have breast implants, there is no need to change your routine medical care and follow-up. ALCL is very rare; it has occurred in only a very small number of the millions of women who have breast implants. Although not specific to ALCL, you should follow standard medical recommendations including:

• Monitor your breast implants. If you notice any changes including lumps, contact your GP promptly to schedule an appointment, as the changes might not be related to your implants. If your GP or any investigations demonstrate the implants are likely to be related to the problem contact your surgeon for an appointment.

If you are considering Breast Augmentation, what is the advice?

If you do not currently have breast implants but are considering breast implant surgery, discuss the risks and benefits with your surgeon. You may also visit FDA’s Breast Implants website for additional information.

For Further information about Breast Surgery, please contact us or request a consultation here. We look forward to meeting you and finding out how we can help.