Are Breast Implants Linked to Cancer?
In 2019 almost 300,000 females had breast augmentation surgery in the U.S. You may wonder, are breast implants linked to cancer? No, breast implants do not directly cause cancer, but women who have undergone this procedure have a higher risk of developing a type of lymphoma, which is a cancer of the immune system.
What the FDA Says
The FDA has issued guidance about the links between certain breast implants and their links to ALCL, including recommendations on what patients and healthcare professionals should do. With this in mind, it is important to know the facts so that you can make an informed decision if you are planning to have a breast implant surgery.
What Is ALCL?
ALCL is anaplastic large-cell lymphoma and is a form of non-Hodgkin’s lymphoma, which is a type of cancer that starts in the body’s lymphatic system. When this is associated with breast implants it is called BIA-ALCL, which is breast implant associated ALCL. It’s important to understand that this is not breast cancer, even though it starts within the scar tissue and fluid which surrounds the implant. This type of lymphoma affects the lymphatic system and starts when T-cells (white blood cells) become abnormal and build up in lymph nodes.
There is uncertainty regarding the link between breast implants and ALCL, but over 90% of females who develop this type of cancer have textured breast implants. Although ALCL can be treated successfully, it can be life-threatening if it is not caught early.
Does the Breast Implant Filling Increase the Risk of Cancer?
Breast implants are either filled with saline or silicone. Breast implants filled with saline, or salt water, look and feel less natural than the silicone equivalents. If the implant ruptures, then for saline implants it is immediately obvious, as it completely deflates, and the body will absorb the liquid safely. If a silicone implant ruptures, then you may not notice straight away as it is usually gradual, and some believe that it is less safe when it leaks into the body. It can cause pain or change the shape of the breast.
In terms of causing cancer, there is no data supporting any increased risk of the type of filling for a breast implant. ALCL is not more prevalent in either silicone or saline implants, although there have been no large-scale studies conducted on the subject yet, making the topic of breast implants linked to cancer quite controversial.
What Are Textured Breast Implants?
Breast implants are either smooth or textured, and the textured ones have a thicker shell which adheres to the tissue in the breast. This means that they are not as likely to move around in the chest and droop or lose their position. Smooth implant shells are softer than textured ones and usually feel more natural. They do move around during activity though, in the same way that a natural breast does. Textured breast implants are less common than smooth ones and only account for 10% of implants used for breast augmentation.
Women who have had expandable textured implants after a mastectomy also have a higher risk of getting ALCL. Expandable implants are often used where the chest muscle needs to be stretched. Once the tissues have healed, saline can be injected into the implant chamber gradually to increase the size of the breast.
How Great Is the Risk?
The risk of getting ALCL is very low as it is a rare type of cancer. For women who have undergone breast augmentation surgery using implants, just 1 in 50,000 will get ALCL. For those who have textured implants the risk ranges from around 1 in 1,000 to 1 in 30,000. Put into context, in July 2019 the FDA reported that 573 women had been diagnosed with BIA-ALCL, of which 33 had died from the disease.
What Are the Signs of ALCL?
Symptoms often do not develop for many years after surgery, but the main sign is swelling, which is caused by an increase in fluid around the implant. Other symptoms include redness in the skin, pain and lumps in the breast or the armpit lymph nodes, rash, fatigue, hardness of the breast and weight loss.
The symptoms are unlikely to occur straight away, with most instances diagnosed within 7 to 10 years after surgery, but some reported as long as 32 years after the procedure. It’s vital that any changes around the implant in your breast should be reported to a doctor.
What Does the FDA Recommend?
In summer 2019 the FDA recalled Allergan BIOCELL textured breast implants because they were associated with most of the worldwide cases of BIA-ALCL, including 12 of the 13 deaths from the disease where the manufacturer was known.
In June 2020 it launched a campaign to reach out to patients who may have been affected to check the type of implant they have and the manufacturer in case they want to take action. Patients who are not sure what type of implant they have are being asked to contact Allergan Aesthetics or their surgeon to get that information.
The FDA does not recommend removal of the BIOCELL implants though as it is still a very low risk of getting BIA-ALCL. However, they suggest that women contact their surgeon or hospital if they have any questions to discuss their options.