Breast augmentation
Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL): Everything You Need to Know Before Breast Augmentation
Hey, it’s Dr. Macys!
As a Board Certified Plastic Surgeon, I believe it’s crucial to keep my patients informed about potential risks associated with breast augmentation implants. Today, I want to discuss Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a rare but important condition that has gained attention in the last decade.
What is BIA-ALCL?
BIA-ALCL is a rare type of lymphoma that can develop in the tissue surrounding breast implants, particularly those with textured surfaces¹. It’s not breast cancer, but rather a type of lymphoma—a cancer of lymphocytic immune system cells. While rare, it’s essential to be aware of this condition if you have breast implants or are considering getting them.
Who’s at Risk?
Recent studies have shed light on the risk factors for BIA-ALCL. A 2024 meta-analysis by Ghoneim et al. found that patients with breast implants were about 29 times more likely to develop BIA-ALCL compared to those without implants². However, it’s important to note that the overall risk remains very low, ranging from 0 to 1 per 1000 cases among patients with implants.³
Interestingly, the risk appears similar for both aesthetic and reconstructive surgeries. The highest risk reported so far (1 in 2,832) has been associated with macro-textured breast implants⁴. Patients with a history of breast cancer were found to have a significantly higher risk of developing BIA-ALCL⁵. Therefore, macro-textured implants have been banned for some time now.
When Does BIA-ALCL Typically Appear?
BIA-ALCL typically develops several years after breast augmentation surgery. The average time to diagnosis ranges from 8 to 10 years post-implantation⁶. However, cases have been reported as early as one year and as late as 27 years post-surgery. Staying attentive to your health and knowing the symptoms is key
What Are the BIA-ALCL Symptoms?
If you have breast implants, it’s important to be aware of the following signs:
- Sudden breast swelling or enlargement
- Pain in the breast
- A noticeable lump
- Changes in breast shape or asymmetry
- Skin rash over the breast
- Hardening of the breast⁷
Diagnosis and Treatment
Early detection is key to successful treatment of BIA-ALCL. If you notice any of the above symptoms, especially if it’s been more than a year since your breast augmentation surgery, it’s crucial to consult your doctor promptly⁸.
The good news is that when caught early, BIA-ALCL is often easily treatable and curable. Treatment typically involves removing the implant and the surrounding tissue capsule. In some rare cases, additional treatments like chemotherapy may be necessary⁹.
Prognosis
Research shows encouraging survival rates for BIA-ALCL, especially when the disease is confined to the fibrous capsule around the implant. One study reported a complete remission rate of 93% for individuals with disease confined to the capsule compared to 72% for those with more advanced disease¹⁰.
For the majority of cases detected early, the outcome is excellent, with many patients achieving complete remission. The chances of complications increase only if the condition is advanced, so regular check-ups are essential.¹⁰
While BIA-ALCL is a serious condition, it’s important to remember that it’s very rare. The benefits of breast implants often outweigh the risks for many patients. However, being informed is crucial. Regular self-examinations and regular follow-up appointments are essential.