If you’ve been keeping your eye on the news, you may have come across an alarming headline this weekend indicating a link between breast implants and a rare form of cancer. Whether you’ve been a patient at The Plastic Surgery Clinic, are considering seeing us for a consultation, or if you’re still in the early process of doing research about breast augmentation, we want to make sure that you have the most accurate and up to date information possible so that you can make informed decisions about your health and your body.
Dr. Ahmad and I perform more breast augmentations than any other type of surgery. As a result, we have a really thorough understanding of all aspects of the procedure. It’s imperative to us that our patients receive the highest level of care possible and so we’ve always made it our mission to stay ahead of the curve on scientific developments. We’ve published a number of peer reviewed articles that cover everything from the aesthetic to the medical concerns that surround breast augmentation, and that includes the risks and complications sometimes associated with breast implants. In fact, just a few weeks ago we were invited to San Diego to teach other plastic surgeons about this exact topic at The Aesthetic Meeting, an annual conference hosted by the American Society of Aesthetic Plastic Surgery. We’ve read all of the information available relating to breast implants and links to cancer and we’ve taught it to other surgeons internationally. What follows is an overview of what we cover in our presentations.
The first thing that’s important to understand is that we know for sure from scientific studies that breast implants do not cause breast cancer. This has been studied exhaustively and we know for certain that there is no connection between the two. The type of cancer that is currently being discussed in the news is actually a very rare type of what’s called a lymphoproliferative disease, where immune system cells, or lymphocytes, become cancerous in the area of the breast. What we’re talking about specifically goes by the name of Anaplastic Large Cell Lymphoma, or ALCL.
ALCL is thought to occur in one in 10,000 cases. Out of the more than 10 million patients who’ve received breast augmentations worldwide, we’ve only seen about 400 cases of ALCL develop. I’ve been a practicing plastic surgeon for over 30 years and I’ve never personally encountered a case. Comparatively, the odds of being struck by lightning in your lifetime are about one in 3,000. I say this not to diminish the seriousness of the 400 cases that have occurred, but to point out how exceedingly rare it is as a condition, as this is also a really important consideration if you currently have the type of breast implants that are most often associated with this lymphoma.
And there is a specific type of implant that tends to cause ALCL. It only occurs in patients with textured implants. We’ve found this is especially true for a very specific subset of textured breast implants, which have a more aggressively textured surface. In the case of an Ontario woman who was featured in a recent New York Times article about breast implants and lymphoma, Biocell implants were used during her breast augmentation in 2009. We stopped using these highly textured implants about five years ago due to information we learned about the risk of other complications associated with them. The fact that ALCL is not seen in smooth breast implants is one reason why they are the only implants we now use.
Another very important thing to know about ALCL is that it’s not a condition that comes on silently. It will not go unnoticed. A patient with ALCL will know something is wrong because a large volume of fluid will develop surrounding the implant, creating a large, swollen breast. When this happens, diagnosis is actually a pretty simple process. A doctor will take some of the fluid and run a CD30 test, which will show a positive lymphoma result.
95% of patients are completely cured of ALCL by simply removing the implant and the capsule (the collagen-fibre tissue that your body forms naturally around the implant). Other treatments we might normally associate with cancer, like chemotherapy, are not needed at all. So for the vast majority of this very small population, we remove the implant and capsule and the patient is cured. Once the disease is cleared, some patients even opt for new breast implants.
If you already have textured breast implants, and especially if you have Biocell breast implants, you might be wondering where to go from here. If you have experienced no signs of complications, our recommendation is to do nothing. The risks associated with surgery, though very rare, are greater than the exceptionally low risk of developing ALCL, and so leaving your implants in place is actually the safest possible option. That being said, if you are at all worried, you should absolutely speak to your doctor. If you develop a sudden swelling of your breast, see your doctor right away.
If you are currently considering breast augmentation, make sure you discuss the risks of ALCL with your plastic surgeon during your consultation, along with any other questions and concerns you might have.
- posted by Dr. Frank Lista, MD, FRCSC