Breast implants and Anaplastic Large Cell lymphoma

Recent reports showed that breast implants are not completely safe. In 2011, the FDA (Food and Drug Administration) reported a possible association between breast implants and the development of certain types of cancers of the lymphatic system called Anaplastic Large Cell Lymphoma.

First, what are the materials used for breast implants? 

There are two major sources for breast implants, silicone (which may be either Silicone fluid (polydimethylsiloxane, PDMS), Silicone gel, or Silicone Elastomer), or a saline implant. The idea of implants (either Silicone or Saline) is to fill the normal breast tissue with a material that creates the shape/contour of the normal breast.

Over decades, Silicone implants have been condemned with many side effects such as the development of skin allergies, breast tissue contracture, breast pain, disfigurement of the implanted breast, and development of foreign body reaction and maybe rejection ( British Medical Journal 2018  https://bmjopen.bmj.com/content/8/4/e020671   ).  However, the new findings by the FDA about the correlation between breast implants (especially the silicone types) and Lymphoma is the first of its kind.

New Research Findings 

According to the United States Food and Drug Administration (FDA) report published in September 2018 https://www.fda.gov/medicaldevices/productsandmedicalprocedures/implantsandprosthetics/breastimplants/ucm239995.htm   out of 660 Medical Devise Reports ( meaning breast implants) related to Anaplastic Large Cell Lymphoma (ALCL), almost 457 were certainly related to the use of these implants

Another high-profile research institute in Australia and New Zealand recently published research on the new phenomenon of the development of Anaplastic large-cell lymphoma for patients who had breast implants. In their research article published in 2017 (Loch-Wilkinson A et al 2017) in the Plastic and Reconstructive Surgery Journal https://insights.ovid.com/pubmed?pmid=28481803    55 patients with breast implants developed Anaplastic Large Cell Lymphoma between 2007 and 2016 and four patients died of the disease during this period.

So, what are the recommendations?

The FDA recommends that physicians be proactive when patients with breast implants develop one or more of these symptoms: late onset and persistent seroma (fluid collection around the implant), persistent breast pain, and swelling. The doctors need to do more work and investigate for possible development of ALCL. Also making patients aware of the breast implant manufacturer’s labeling as some of the implants ( especially the textured surface implants) were found to be linked to the risk of development of lymphoma. Also, any suspicious mass/swelling should alert the treating physician to take a biopsy from this lump and look for the possibility of having ALCL. Additionally, teaching patients the different types of implants, their pros and cons is of paramount importance to guide them through the best choice for them and to avoid any possible late effects.

 
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