Breast implants linked to rare cancer

Breast implants have been around for decades, but experts recently discovered a concerning link between breast implants and a type of cancer. (KATV photo)

Breast implants have been around for decades, but experts recently discovered a concerning link between breast implants and a type of cancer.

"It's a rare type of blood cancer, lymphoma, that they were finding in a very small subset of women that had breast implants," explains Dr. Erin Wright, a plastic surgeon at UAMS who specializes in breast reconstruction.

Breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL, was first reported in 1986.

"Implants have been out since the 1960s and we just started hearing about this over the past several years so we believe that something has changed," Dr. Wright explained. "Either the implants themselves, particularly this textured implant may be responsible, or that it's been under-reported for the past several years and we're just now starting to see the effects of it."

The association between ALCL and breast implants wasn't identified by the FDA until 2011. Since then, the FDA and World Health organization has done more thorough studies, focusing on the relationship between breast implants and this particular type of cancer, which usually shows up about 8 to 10 years after the initial implant.

Dr. Michael Spann with Little Rock Plastic Surgery explained to us the different type of implants. There are silicone and saline fill implants, and smooth and textured surface implants. The texture on implants is designed to minimize movement, acting as a sort of velcro to tissue surrounding it.

The problem has only been linked to textured-surface implants. Silicone and saline fills have equal instances of ALCL and do not appear to be a factor.

"What we think as plastic surgeons is this is some kind of chronic inflammation that is causing the cancer to proliferate," Dr. Spann explained. "Anywhere you have chronic inflammation there's a potential for our body to turn on itself to cause some kind of inflammatory process that may evolve into a cancerous process."

Doctors are studying the type of lymphoma to better understand the cause.

"To have a t-cell lymphoma is extremely rare," Dr. Appalanaidu Sasapu, a lymphoma expert at UAMS, told us. "So within that rarity, when you are seeing these random cases of T-cell lymphomas in patients with breast implants, that was a sign that you know what, it was not a natural thing."

This type of lymphoma associated with breast implants so rare, that Dr. Sasapu says it's found in less than 1 case per 10 million people.

In fact, he says almost no one without breast implants has this same type.

"The World Health Organization actually put it as a separate entity called breast implant-associated Large cell lymphoma. It's a separate entity in the lymphoma classification. It was never put that way in the past," Dr. Sasapu says.

That change was just made last year. But Dr. Spann says it's now being reported in other types of implants.

"The fact of the matter is this is not just breast implants. So there have been more of these cases reported world wide in hip implants, knee implants, around catheters under the skin," Dr. Spann says. "So this is a foreign body reaction in the body, not a breast implant only disease."

As doctors learn more about it, they learn how to better treat it.

Dr. Sasapu says for BIA-ALCL, the main treatment is to remove the implant with the capsule, a procedure called a capsulectomy.

Based on pathology reports, radiation or chemotherapy may be recommended. But Dr. Sasapu says in 70 percent of cases the capsulectomy is enough, adding that if caught early, treatment is usually successful.

Just two months ago, the FDA updated their findings. Of the 359 women they've identified with this type of cancer, there have been 9 deaths.

But there are also about 10 million women with breast implants.

"I think the most important thing to keep in mind is all surgery has risk," Dr. Spann said. "Do breast implants cause cancer? I think the answer is no, in most cases. I mean, 1 in 300,000 is a low chance."

"It's still such a very rare event that the plastic surgery society and the FDA still feels that implants are safe," Dr. Wright said. "But it is something that ongoing research is taking place and we have to make an educated decision together."

At this point, all three doctors agree the most important thing for patients with textured implants is to follow up with your doctor, and report any symptoms such as swelling, lumps, or pain.

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