On Wednesday, January 26th, 2011, the FDA announced that women with saline or silicone breast implants may incur a “very low but increased risk” of developing Anaplastic Large Cell Lymphoma (ALCL). ALCL is not breast cancer, but rather a rare malignant tumor that is a form of Non-Hodgkin’s lymphoma. It may occur in lymph nodes, skin, bones, soft tissues, liver and lung, as well as in the breast in very rare instances. The incidence of ALCL in the breast is 3 in 100,000,000 women per year in the US. There are a total of 60 reported cases of ALCL in women with breast implants, and in these patients malignant cells are found in the fluid (seroma) surrounding the implant or in the scar tissue (capsule) around the implants, rather than in the breast tissue itself. ALCL has most often been identified in patients undergoing breast implant operations and presenting with late onset, persistent seromas. Symptoms usually include persistent swelling or pain around the breast implant, a palpable mass or visible asymmetry. Often these symptoms present a long time after normal healing has occurred post-operatively.
It has not yet been determined if saline or silicone implants carry a higher risk of developing ALCL, or if smooth or textured implant surface plays a factor in developing ALCL. In asymptomatic women, breast implant removal is not recommended. In patients with symptoms such as pain, lumps, swelling or changes in the appearance or feel of their breast implants, especially if late in onset after surgery, consultation with their physician is indicated for appropriate evaluation and management. A mammogram and/or MRI may be recommended. ALCL in patients with breast implants usually follows an indolent course, and is treated with explantation of the implants and surgical capsulectomy.
The complete summary of the FDA’s findings may be found in a document titled Anaplastic Large Cell Lymphoma (ALCL) in Women with Breast Implants: Preliminary FDA Findings and Analyses.
If you are considering breast augmentation with either saline or silicone breast implants, make sure you discuss all aspects of the surgery, as well as risks and complications, with your plastic surgeon. To make an appointment with Dr. Hutchinson, please click here to contact our office or call us at (212) 452-1400.
