What is breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)?
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of non-Hodgkin’s lymphoma, specifically a T-cell lymphoma, that can develop in some people with breast implants. This condition is not a form of breast cancer but rather a cancer of the immune system, and it is associated with the capsule surrounding the breast implant rather than the breast tissue itself. Although BIA-ALCL is rare, it’s essential to be aware of it, particularly if you have or are considering breast implants.
BIA-ALCL is most commonly found in people who have textured-surface breast implants, although it has been reported in those with smooth implants as well. It usually develops in the scar tissue, or capsule, surrounding the implant. Over time, a fibrous capsule forms around any implanted device as part of the body’s natural immune response. In some cases, cells within this capsule may start to change, leading to the development of BIA-ALCL.
What are the symptoms of BIA-ALCL?
The most common symptoms of BIA-ALCL are persistent swelling or pain in the breast area. This is often due to fluid accumulation (seroma) around the implant, which can occur months or even years after the initial implant surgery. Other symptoms may include:
- Lump formation near the implant or in the lymph nodes
- Skin rash
- Asymmetry of the breasts due to swelling on one side
- Hardening of the breast or implant area
It’s important to note that these symptoms do not automatically indicate BIA-ALCL. However, if you experience any of these symptoms, particularly swelling or a palpable mass around the implant, you should seek medical attention for further evaluation.
Causes and risk factors
While the exact cause of BIA-ALCL remains unclear, research suggests that textured implants, specifically, may increase the risk as they provide more area for bacteria to grow, which can potentially lead to chronic inflammation. This inflammation is thought to play a role in the cellular changes that lead to lymphoma in some individuals.
Additional factors that may increase the risk include:
- Type of implant surface (textured implants have a higher association)
- Duration of implant presence (BIA-ALCL has been diagnosed years after implant surgery)
- Genetic predisposition to immune system conditions
Despite these findings, BIA-ALCL remains very rare, with cases in the UK being very limited relative to the number of people with breast implants.
How is BIA-ALCL diagnosed?
If BIA-ALCL is suspected, your doctor may perform several tests to diagnose the condition accurately. These may include:
- Ultrasound or MRI to detect fluid around the implant or any mass
- Fine needle aspiration to collect fluid for analysis
- Biopsy of the capsule or tissue around the implant if a lump or mass is present
The analysis will look for specific markers in the fluid or tissue that indicate lymphoma. Early diagnosis is crucial to improve outcomes, as it allows for timely treatment.
Treatment options
Treatment for BIA-ALCL typically involves surgery to remove the implant and the surrounding capsule. In many cases, complete removal of the implant and capsule is effective in curing the disease. In situations where the lymphoma has spread to nearby lymph nodes or other parts of the body, additional treatments such as chemotherapy or radiation may be required.
Monitoring and prevention
If you already have breast implants, it’s essential to stay vigilant for any symptoms, particularly new swelling, lumps, or changes in breast shape. Routine follow-ups with your healthcare provider are also beneficial. Removal of textured implants in asymptomatic individuals is not currently recommended, as the risk of developing BIA-ALCL remains very low.
For those considering implants, it’s essential to discuss the risks with your surgeon. In recent years, the availability of smooth implants has increased, and these may present a lower risk of BIA-ALCL. Your surgeon can provide guidance based on the latest recommendations and your personal risk factors.
Why choose Birmingham Breast Clinic?
At Birmingham Breast Clinic, we provide expert care in breast health, including comprehensive diagnostic and treatment options for rare conditions like BIA-ALCL. We prioritise patient education and support, helping you make informed decisions about your health.
Contact us
If you have any concerns about breast implants or symptoms related to BIA-ALCL, please don’t hesitate to contact s. Our team is here to provide the guidance and care you need.
