Most women who have breast implant surgery never develop complications. For very few people, especially those who have textured implants, it is possible to develop a condition known as breast implant associated anaplastic LARGE cell lymphoma (BIA-ALCL), a type of cancer. This cancer typically forms in the scar tissue surrounding the implant, but it can spread to other areas of the body.

Understanding your risk of having BIA-ALCL is critical if you have had breast implant surgery. With proper care and immediate attention, this cancer has a high cure rate. Dr. Julie Khanna, a leading cosmetic surgeon serving Canada for over 25 years offers insight from her experience in helping clients through BAI-ALCL. “1 in 8 women will get breast cancer in our lifetime,” shares Dr. Khanna. “That’s with or without implants and that’s without any family history. So please, please, please listen to your primary care physician” and get the screenings you need.

What Is BIA-ALCL?

Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is a very rare type of T-cell lymphoma, a type of cancer impacting the immune system. This specific form of cancer develops the capsule of scar tissue that forms after implant surgery. This capsule is normal, and tends to be very soft and natural feeling. Dr. Khanna states it’s important to know that it is “not breast cancer but blood cancer in the breast.”

In some women, this cancer, which is not a form of breast cancer itself but rather a blood-based cancer, forms within the tissue that adheres to and forms within the capsule surrounding the breast impact. Researchers have found that it is most likely to occur when the implant is textured rather than smooth.

How Common is BIA-ALCL?

While all people with breast implants should know about BIA-ALCL, it’s important to know it’s a rare type of cancer. The Food and Drug Administration states that as of June of 2023, they have had 1264 recognized cases of BIA ALCL reported. Of those reported cases, just 3 to 5% of people with this cancer have experienced it spreading to other areas of the body. It is clear, then, that there is a low risk and an even lower risk of developing life-threatening cancer if the condition is observed and treated.

However, this is also a very limitedly understood condition. The number of cancers reported could be low. More so, researchers are still working to understand why it forms in some women and why it does not in others.
Specifically, all BIA-ALCL cases have been diagnosed in people who have textured implants, specifically BIOCELL textured implants from Allergan. The company has discontinued implanting these products as a result of this very high risk.

Symptoms of BIA-ALCL

Symptoms of BIA-ALCL can be hard to detect in some people. However, one of the most important and common symptoms is the rapid development of fluid in one breast or around one breast implant. In some situations, this can occur within a matter of hours or a few days, often leading to swelling or the development of a lump next to the surface of the implant or extending into the armpit area.

BIA-ALCL symptoms may develop 7 to 10 years after the breast implant. They may occur sooner than this.

Some women also experience skin rash, fever, enlarged lymph nodes, and unexplained weight loss. In situations where multiple symptoms occur, or there is swelling in both breasts, it is still beneficial to reach out to a doctor to be examined for large cell lymphoma BIA cancer.

Core signs warranting contacting a doctor include the following:

  • Breast enlargement often on one side more so than the other
  • Pain development in the area of the swelling
  • Fever or unexplained illness, including swelling of the lymph nodes
  • Lumps that develop in or around the armpit or breast
  • Hardening of the breast

The sooner this cancer is detected, the sooner it can be removed. This can make it critical for individuals to seek care any time they begin to notice a change in their implants or the tissues surrounding the area.

Diagnosing BIA-ALCL

To diagnose BIA-ALCL, doctors will provide a physical examination. From there, additional tests may be requested, including an ultrasound, biopsy of the area, and lab testing. Typically, an MRI will provide information about fluid buildup around the implant, which may then encourage doctors to take a sample of that fluid using a needle aspiration. This fluid is then examined. Doctors should test for CD-30, a specific type of protein found in lymphoma cells, including those that make up BIA-ALCL. If found, another test for anaplastic lymphoma kinase (ALK) is then completed.

If you have textured breast implants and you are concerned about the risk of developing BIA-ALCL due to any of the symptoms mentioned here, consult your doctor right away.

Treatment Options for BIA-ALCL

Treating BIA-ALCL is often done with the support of an oncologist, who will complete further evaluations to create a treatment plan. This may include the completion of a PET scan to determine the locations of cancer in the body.

Surgical treatment removal is often recommended. This procedure typically involves the removal of the implant and the surrounding capsule of scar tissue where any masses are present. For some people, this is the only necessary step.

This is the recommended treatment for according to the National Comprehensive Cancer Network (NCCN) guidelines for treating BIA-ALCL. With en-bloc capsulectomy, which removes the breast implant and surrounding scar tissue in a single section, as well as surrounding tissue, and complete surgical excision, the survival rate is very high, and an event-free survival is possible. In those who have not had cancer spread to other areas, the survival rate is as high as 95%.

The Role of Textured Breast Implants

One of the largest risks for developing BIA-associated anaplastic large cell lymphoma stems from having textured breast implants. The risk of developing BIA-ALCL is much higher in those who have this particular type of implant. While researchers are not sure what the connection is, the deep pockets of these implants or areas may harbor a higher risk for bacteria growth.

Preventative Measures and Recommendations

There is no way to prevent the onset of BIA-ALCL. However, early detection saves lives. This can be done through:

  • Monthly breast self-examinations
  • Annual breast checkups
  • Reporting any new lumps or tissue changes to your doctor immediately
  • Report any changes in breast appearance or pain to doctors, including the surrounding scar tissue

Not that the typical mammogram will not detect this type of breast cancer. Additional monitoring is necessary for the symptoms of BIA-ALCL.
If you are considering the use of breast implants, talk to your doctor about the safety concerns you have and consider alternative forms of breast implants that do not have textured surfaces.

Get Help from ICLS If You Are At Risk for Breast Implant Cancer

If you have breast implants and believe you are at risk or want to be sure you are not at risk, set up a consultation with our team at ICLS. Dr. Khana is readily available to offer help.

Frequently Asked Questions

  • Is BIA-ALCL treatable?

    Early detection is critical, but when it occurs, BIA-ALCL is treatable through the removal of the implant and impacted tissues surrounding it.

  • What are the first symptoms of BIA-ALCL?

    Though self-exams could detect concerns earlier, one of the most notable signs is a rapid swelling of one breast and the development of pain in that area. In some cases, this can occur in just a matter of hours.

  • What type of cancer is BIA-ALCL?

    BIA-ALCL is a type of large cell lymphoma, a type of cancer that develops in the fluids and scar tissue surrounding a breast implant. It is a type of blood cancer.