BIA-ALCL - Breast Implant Associated Anaplastic Large Cell Lymphoma

BIA-ALCL - Breast Implant Associated
Anaplastic Large Cell Lymphoma

In March 2017, the FDA issued a warning confirming that breast implants cause BIA-ALCL cancer which is a cancer of the immune system; however, the history of breast implants causing breast implant associated lymphoma cancer and other cancers goes much farther back. The first case of lymphoma due to breast implants was reported in 1997, and now as of August 2019, there are 706 confirmed cases and 33 deaths. The actual number of cases of BIA-ALCL is likely to be much higher because identification of and testing for BIA-ALCL has just recently been acknowledged by the ASPS and historically not readily acknowledged or available to women.  Further, in past years the ASPS actually worked to minimize BIA-ALCL recognition but due to recent years of activism by ladies with BIA-ALCL around the world this breast implant associated disease has been brought to light.  

So far, all cases of BIA-ALCL have been associated with textured implants or expanders and certain kinds of offending textured breast implants have been removed from the market by several countries during 2019.  But many women still have textured breast implants in their body and as more testing for BIA-ALCL occurs the incidence rates are steadily increasing and recent statistics show it to be approximately 1:2,200 and higher.  

It should be no surprise to breast implant manufacturers, Health Canada and the FDA that silicone and breast implants cause cancers, systemic illness, autoimmune and other profound diseases because silicone is made with several carcinogenic and inflammatory chemicals which has been kept hidden from the general public by breast implant manufacturers and seemly of no concern to the FDA and Health Canada who regulate these devices.  It’s of no concern to the FDA despite their knowledge of several decades of illness to many hundreds of thousands of women who made advese event reports, despite previous class action lawsuits against past silicone breast implant manufacturers and despite the fact all except the general public and consumers knew there was never any long term safety studies of breast implants done.  If consumers were made aware of the toxic chemicals and heavy metals in silicone and breast implants and the fact they leak their contents and rupture much earlier than you expect, they would not consider putting them inside their body.     

If you have textured implants or expanders and the below outlined symptoms of BIA-ALCL, ideally you need to find a knowledgeable plastic or breast reconstruction surgeon and push for testing prior to explant.  The benefit of testing for BIA-ALCL prior to explant (explant is generally the main indicated treatment) is that if you are found to be positive for BIA-ALCL it triggers a certain protocol of treatment to be followed which will likely provide an overall better prognosis for you.  There are various presentations of BIA-ALCL in women which can be fluid, masses and other symptoms.  An ultrasound and MRI is usually the first step if you have textured implants and symptoms of BIA-ALCL but this should be discussed with a BIA-ALCL knowledgeable plastic, breast surgeon or doctor.  Below is more information about testing and treatment protocols. 

Breast Implant Associated Anaplastic Large Cell Lymphoma Diagram

BIA-ALCL Breast Implant Associated Lymphoma is a type of non-Hodgkin’s lymphoma, a cancer of the cells of the immune system (not breast cancer) that can be caused by breast implants.   The main symptoms of BIA-ALCL are persistent swelling or pain in the vicinity of the breast implant, seroma, breast mass, capsular contracture, swollen lymph nodes and are associated with textured implants. These symptoms may appear after the implant surgical incision has healed and often can appear years after implant placement. If you have swelling, pain, seroma, breast mass, capsular contracture or swollen lymph nodes and textured implants please push hard for BIA-ALCL testing.  Surgeons should consider the possibility of ALCL when they have a patient with late onset, persistent fluid around the implant (peri-implant seroma) before and or during explant or exhibit the symptoms after explant. When testing for ALCL at the time of explant, surgeons should collect fresh seroma fluid and representative portions of the capsule and send for pathology tests. The test is called CD-30 Immunochemistry and few plastic surgeons are knowledgeable about BIA-ALCL at this point so it will be up to you to educate your plastic surgeon and persist in getting the test if you have any symptoms and/or textured implants.

Here are the FDA’s recent announcements and information on BIA-ALCL:

https://www.fda.gov/MedicalDevices/Safety/LetterstoHealthCareProviders/ucm630863.htm

https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239995.htm

https://www.fda.gov/medical-devices/medical-device-recalls/allergan-recalls-natrelle-biocell-textured-breast-implants-due-risk-bia-alcl-cancer

Here is the 2020 NCCN Consensus Guidelines on Diagnoses and Treatment of BIA-ALCL:

https://biaalcl.com/wp-content/uploads/NCCN-Guidelines-January-2020.pdf?fbclid=IwAR0SthxCy033cOv7OI8HS4Et9KlPWUsdGI27IXgGHW4MGkQOXV7sEDh987c

https://academic.oup.com/asjopenforum/article/1/1/ojz005/5366236?fbclid=IwAR3fekRhQDpWig5s6qi8n96YPfL0P0kKI5fI090Mf4-nEotMpIekQAuoAPo

Here is the American Society of Plastic Surgeons’ current information on BIA-ALCL:

https://www.plasticsurgery.org/for-medical-professionals/health-policy/bia-alcl-physician-resources/frequently-asked-questions

https://www.plasticsurgery.org/for-medical-professionals/health-policy/bia-alcl-physician-resources

Here is the Canadian Society of Plastic Surgeon’s current information on BIA-ALCL

https://drive.google.com/file/d/1FXeD3dOVniCWap21tKzrMw3Am5qsq68f/view?fbclid=IwAR1Bg0QS2YZgiKAmko9kWKJ1dgdPVe-9XrU5F60fAPBxlZaXJ7aR8acTpCc

Please join a facebook group in regard to BIA-ALCL:

https://www.facebook.com/groups/ALCLinwomenwithbreastimplants/

Here is a recent website devoted to BIA-ALCL which has more information:

BIA-ALCL Breast Implant Associated ALCL

Please join our Facebook group of over 100,000 women for support through your healing journey.

We look forward to your comments, feedback and personal stories about your symptoms due to breast implants. Please see the comment form below. Thank you.

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