Breast implants and cancer development - latest news on breast implants

Our plastic surgeons are receiving a lot of inquiries from women with breast implants following a news story in November that a French study has shown a link between a certain type of breast implant and lymphoma. They have therefore written an article about the risk of developing BIA-ALCL (Breast Implant-Associated Anaplastic Large-Cell Lymphoma). Read it here.

By Benedikte Thuesen and Trine Foged Henriksen

We have recently received a lot of inquiries from women with breast implants who are concerned about developing cancer from their silicone breast implants and ask if we recommend that they have them removed. This reaction is due to the headline from TV2 on November 27, 2018:
France raises alarm over link between cancer and implants.

Allergan textured implants taken off the market
As of December 20, 2018, Allergan brand textured implants can no longer be marketed in Europe as they are no longer CE marked (European quality and safety approval). The reason is that Allergan textured implants are more common than other implant brands among women diagnosed with the rare cancer Breast Implant-Associated Anaplastic Large-Cell Lymphoma (BIA-ALCL). Allergan implants are among the most commonly used in the world.

BIA-ALCL (Breast Implant-Associated Anaplastic Large-Cell Lymphoma) is not breast cancer, but a form of lymphoma that in very rare cases can occur in the connective tissue around breast implants. The French health authorities have decided not to renew Allergan's CE approval until further evidence of safety is available. At the same time, the French health authorities recommend using smooth surface implants for breast augmentation surgery and breast reconstruction until a consultation on ALCL has been held. The other health authorities consider that there is currently no indication for this recommendation.

Complications associated with BFO
Breast augmentation surgery is one of the most sought-after plastic surgery procedures in the UK. Worldwide, it is estimated (according to a recent estimate) that 30-35 million women have had silicone breast implants implanted. Breast implants are among the most commonly used and well-researched implants in the world. Textured implants are the most popular, due to the fact that they reduce the risk of capsular contracture (the breast becoming hard) and that teardrop-shaped implants rotate.

As with all surgical procedures, there is a risk of complications associated with the surgery. The most common complications are infection, blood pooling, sensory disturbances, capsular contracture (the breasts become hard due to the connective tissue around the implant becoming thick and tight) and leakage of the implants.

Most recently, a possible link has been found between breast implants and a minimal increased risk of developing a form of lymphoma: Breast Implant-Associated Anaplastic Large-Cell Lymphoma (BIA-ALCL). There have been 615 cases of BIA-ALCL registered worldwide since 1997, out of the approximately 30-35 million women who have breast implants (i.e. a risk of well below 1 per thousand). Of these, 17 patients have died. So it is an extremely rare condition.

Symptoms of BIA-ALCL
The most common symptom of the disease is acute, painful, severe swelling of one breast due to fluid around the implant, often occurring years (often more than 10 years) after the implants have been placed. However, you can also get a completely harmless collection of fluid around an implant. If you experience significant swelling, you should contact your doctor or plastic surgeon for an examination.

It is not known why some women develop this extremely rare cancer, but it is likely a combination of different factors such as genetic predisposition and the development of biofilm (bacteria), as well as different manufacturing techniques of the implant surface. This suggests that implants with a coarse texture (rough surface) are more likely to develop BIA-ALCL than implants with a lighter texture.

Risk of developing BIA-ALCL
An Australian study found a 1 in 3,800 lifetime risk of developing BIA-ALCL with Allergan breast implants (which are coarse-textured implants), while the risk with Mentor implants (which are fine-textured implants and which we use at Capio CFR) is 1 in 66,000. This is extremely rare considering that 1 in 10 women develop breast cancer.

In the US, there is also a lot of talk about whether implants can trigger autoimmune diseases (such as rheumatoid arthritis, Sjogren's disease and Raynaud's disease): the symptoms are called ASIA syndrome or breast implant illness (BII). In the past, very large international studies have disproved this. And a recent large meta-analysis has also found no link between implants and long-term health effects.

Breast implants are safe
Therefore, the conclusion among breast surgeons and plastic surgeons worldwide is that breast implantsare safe, but havevery rare, sometimes serious, side effects("Breast implants are safe, but have very rare, sometimes serious, side effects").

It is NOT recommended that you have breast implants replaced or removed, even if you have Allergan or other textured implants. However, if you develop persistent fluid around your breast implant, lump formation in the breast or adjacent lymph node region (armpit or above the collarbone), you should contact your doctor or plastic surgeon for a clinical examination and ultrasound scan. Fluid will be aspirated from the swollen breast or a tissue sample will be taken. The diagnosis is made by microscopy. If you are found to have the rare cancer ALCL, the treatment is to remove the implants, the fluid and the surrounding connective tissue capsule. The vast majority of people will be cured with this treatment.

Read more about plastic surgery at Capio here

Published on December 6, 2022