Update on ALCL and Breast Implants

I wanted to give an update on the latest information regarding the recent FDA announcement of a possible association of women with breast implants and the development of Anaplastic Large Cell Lymphoma (ALCL). Last Thursday there was a live webinar conducted by our two leading national societies, the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons, during which the Presidents from each society presented the information known about this condition and recommendations for our patients. In a nut shell, these are the important facts:

1. ALCL is a very rare condition. Only between 34-60 cases worldwide, for both cosmetic and reconstructive reasons, have been reported since 1985. Considering how many women have had breast implants, this translates to about 1 in 500,000 women who have breast implants. To put this in perspective – breast cancer (as you normally think of breast cancer) occurs in 1 in 9 women. Therefore it is about 60,000 times less likely of developing ALCL than breast cancer.

2. In the reported cases of ALCL, women had their implants for an average of 8 years. They all had developed a new occurrence of pain, lumps or a an enlarging seroma (fluid around the implant). The importance of this is that women who are not having any problems do not need to worry. If you should develop sudden onset of swelling years after having your surgery we recommend seeing your Plastic Surgeon who can then guide you as to proper treatment. Also remember that even if you should find a lump, have pain, or even develop late swelling, it is unlikely to be caused by ALCL, and more likely to simply be related to mechanical problems with the implant such as rupture, breakage or leakage.

3. All the women in the reports were cured simply by removing the implant and surrounding scar tissue, called the capsule (capsulectomy). ALCL related to breast implants appears to be a very indolent, slow growing condition, which does not spread, and is easily treated.

The bottom line – there is absolutely no reason to panic. Women should continue performing routine self breast examination as a matter of good health awareness. Women who are doing well and not having any problems do not need to do anything special. The FDA states that there is no reason for women who are asymptomatic to have their implants removed.

I hope this helps anyone concerned. Please feel free to write back with questions.

Dr. S