Breast implant cancer risk likely underreported
"We're seeing that this cancer is likely very underreported, and as more information on this type of cancer comes to light, the number of cases is likely to increase in the coming years," said researcher Dino Ravnic, MD, Penn State College of Medicine assistant professor of surgery.
To learn more about how the breast implant-linked rare lymphoma is diagnosed and treated and the risk factors for the cancer, Ravnic and colleagues analyzed 115 research articles involving 95 BIA-ALCL patients (five of whom died). The researchers found virtually all of those cases were associated with textured implants.
"All manufacturers of textured implants have had cases linked to this type of lymphoma," Ravnic said. "But in many of these cases the implant was removed without testing the surrounding fluid and tissue for lymphoma cells, so it's difficult to definitively correlate the two."
How textured breast implants may pose cancer risk
More research is needed to identify the specific mechanism behind the textured breast implant cancer risk. The FDA notes several studies have raised questions about whether the method used to create the surface texture of the implants plays a role in causing the cancer. The accumulation of a biofilm (a slime-like film of bacteria) on the textured implants may also be involved in the cancer risk.
Previous research has identified chronic inflammation as a cause of lymphoma. And after reviewing the studies of BIA-ALCL, the Penn State research team believes inflammation surrounding the textured breast implant could be what raises the risk of lymphoma — because tissue growing into the tiny holes in the textured implant may increase and prolong inflammation.
How women with textured breast implants can protect themselves
The Penn State researchers recommend surgeons communicate the risks of BIA-ALCL to patients who are considering breast implants.
If you have textured breast implants, don’t panic. The FDA does not recommend having textured implants removed unless you develop symptoms that suggest BIA-ALCL — including pain, lumps, swelling, and asymmetry in one or both breasts.
Remember, the risk for BIA-ALCL is relatively low and, if lymphoma does develop, it usually progresses slowly. The Penn State researchers found the majority of BIA-ALCL patients who had both their implants and surrounding scar tissue removed had a good prognosis.
Advice from the FDA if you have any kind of breast implants:
- Follow your doctor's instructions on how to monitor your breast implants. If you notice any changes, make an appointment for an exam.
- Have routine mammography screenings by a technologist specifically trained to perform mammograms on patients with breast implants.
- If you have silicone gel-filled implants, talk to your doctor about periodic magnetic resonance imaging (MRI) to detect ruptures.
February 27, 2020
Christopher Nystuen, MD, MBA