Anaplastic Large Cell Lymphoma in Breast Implant Patients

ALCL arising around breast implants

Breast Implant-associated ALCL

Although breast cancer is a relatively common disease (1 in 8 women, lifetime risk), less than 0.5% of these cancers are Non-Hodgkin’s Lymphomas. Historically, the few rare cases of breast lymphoma that have occurred have been B-cell Lymphomas. In the last few years, there have been about 42 cases diagnosed of T-cell Lymphomas in women with breast implants in place.  Thirty-five of these cases have been the rare ALCL type, Anaplastic Large Cell Lymphoma, found within the breast capsules surrounding breast implants. ALCL has been previsously shown to occur as a primary entity within the skin. Those particular types of Lymphomas have a fairly good survival rate: the ten year survival is over ninety percent. Investigators think that this new breast implant-associated ALCL may behave in a similar fashion as the cutaneous types have. A recent article (Taylor, Webster and Prince, Anaplastic Large Cell Lymphoma and Breast Implants: Five Australian Cases,Plast Recon Surg, Vol 129, No 4, p808, April 2012) has provided an update to this new entity.

According to the article, the diagnosis of ALCL should be considered in any patient who presents with a peri-prosthetic seroma formation six months or longer after they had their implants put in.  Historically, there have been no studies that have linked any types of breast cancer to breast implants. However, older studies that looked at breast cancers that occurred in patients with breast implants did not report on the occurrence of lymphomas in the breast.Currently, there have only been about 42 cases of T-cell lymphoma associated with breast implants reported in the literature. Thirty-five of these cases were ALCL, Anaplastic Large Cell Lymphoma. Of cases that have been reported, they have occurred in patients with both saline and silicone implants. However, in one of the studies all of the patients who had developed ALCL did so in the presence of textured implant devices. Of the previously reported patients who developed breast implant associated ALCL (37 cases, of which only 31 had complete data) available in the literature, 13 of the cases occurred in patients with SALINE implants. In all of the cases that were reviewed that had accurate data available, textured surface implants were used. Although inconclusive, these cases suggest that the entity of breast implant associated ALCL occurs only in the presence of textured surface breast implants, irrespective of being filled with saline or silicone. Importantly, all but two of the patients that have developed this diagnosis have had a good prognosis.

If you have developed swelling of one breast more than six months after breast augmentation surgery and are considering breast implant removal, you should contact Dr. Brenner.