Breast implant associated - anaplastic large cell lymphoma (BIA-ALCL)

What is breast implant associated-anaplastic large cell lymphoma (BIA-ALCL)?

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is a rare form of non-Hodgkin’s lymphoma, which is a cancer of the immune system.

It is not breast cancer – which forms from cells in the breast). BIA-ALCL is a cancer of the lymphatic system.

If you have had textured breast implants at any time in your life, you have a low risk of developing this cancer.

What are the symptoms of BIA-ALCL?

The symptoms of BIA-ALCL include:

• Unexplained breast swelling.
• Fluid around your breast implant.
• Less commonly, there may be a lump in the breast or in the armpit.

When do symptoms of BIA-ALCL appear?

Symptoms can arise any time after breast implant surgery.

Nearly all diagnoses are made between 3 and 14 years after surgery.

The average time to diagnosis is 8 years.

How do I check for symptoms of BIA-ALCL?

You can check for symptoms of BIA-ALCL:

• Get to know the normal look and feel of your breasts.
• Self-examine breasts regularly (such as in the bath or shower).
• Remember to examine your armpits and up to your collarbone.

If you notice any changes, or you have any concerns, see your doctor.

Who can get BIA-ALCL?

This rare cancer can occur in people who have had cosmetic or reconstructive breast implant surgery.

The level of risk depends on the type of implant you have. People who have highly textured implants seem to be at the greatest risk (between 1 in 2,500 and 1 in 25,000).

This risk significantly decreases with a decrease in texturing of the implant.

How do I know if I have the type of implant associated with BIA-ALCL?

You may not know if you have a textured or smooth implant.

If you had surgery after 2015, you can access information about your procedure and what type of implants were used through the Australian Breast Device Registry Tel. (03) 9903 0205.

If you had surgery before 2015, an earlier registry – the Breast Implant Registry Tel. (02) 9437 9200 may have your implant details.

Your surgeon or the health service where the procedure was undertaken may also be able to tell you what type of implants you have.

Regardless of what type of implants you have, it is always good to regularly check for lumps and unexplained swelling.

How is BIA-ALCL diagnosed?

If you have an unexplained swelling or a lump in one of your breasts, your doctor may refer you for diagnostic screening and blood tests. Any fluid that is present will also be tested.

If confirmed, your specialist may also order an MRI scan or CT scan to assess the extent of local growth or spread of the cancer.

Other tests, such as a PET scan, may be also used to assess spread.

What is the treatment and prognosis for BIA-ALCL?

Survival rates are high. Early diagnosis and treatment will lead to better outcomes and increased chances of recovery.

Usually both implants will be removed to treat BIA-ALCL. If there is a solid lump or the cancer has spread, you may also need:

• chemotherapy
• radiotherapy
• additional surgery
• additional CT scans for follow-up monitoring.

A treatment plan may be developed with advice from a:

• blood disease specialist with experience with lymphomas
• cancer specialist
• breast surgeon.

Should I get my implants removed?

If you do not have symptoms, there is no reason to remove your implants.

If you are worried, please speak to your GP. Or for information about the risks, symptoms, diagnosis and treatment, call the dedicated Victorian consumer helpline on Tel. (03) 9902 0077.

What if I’m thinking about having breast implants?

Some breast implants have been associated with a higher risk of BIA-ALCL.

Speak with your surgeon about the risks and which implants are safe.

Where can I find information on BIA-ALCL and breast implant safety?

Australia’s Therapeutic Goods Administration (TGA) has created two expert panel led webinars on breast implant safety. Topics include :

• BIA-ALCL and breast reconstruction surgery
• BIA-ALCL and breast augmentation surgery

Where to get help

• Your GP (doctor)
• Your surgeon
• Australian Society of Plastic Surgeons Information Hotline Tel. 1300 367 446
• Royal Australasian College of Surgeons Tel. (03) 9249 1200
• Australian Breast Device Registry Tel. (03) 9903 0205 or 1800 998 722
• Breast Implant Registry (for surgery before 2015) Tel. (02) 9437 9200
• Oncologist
• The Therapeutic Goods Administration (TGA)
• Cancer Council Victoria