What Are the Symptoms of BIA-ALCL?
The most common presentation is as a persistent swelling of the breast due to fluid collecting around the implant
Less commonly, It can present as a lump in the breast or armpit
It usually develops 3 to 14 years after the insertion of breast implants.
What is the Risk of Developing BIA-ALCL?
No woman who has only had smooth breast implants has developed BIA-ALCL.
The risk of developing BIA-ALCL with textured or polyurethane implants depends upon the type of implant.
It is a rare condition, with expert opinions estimating the published risk of BIA-ALCL at between 1-in-2,800 and 1-in-86,000.
For perspective, the risk of breast cancer is close to one in eight and the life risk of a woman living to 84 years of developing lymphoma (not-implant related) is one in 50
What is the Treatment of BIA-ALCL?
The vast majority of cases are cured with the removal of implants and the fibrous capsule around them from both breasts (there is a rare incidence of bilateral disease)
All women treated without a delay to diagnosis and with appropriate management principles have resulted in complete remission
Dr Eddy Dona is a highly experienced specialist plastic surgeon who has dedicated much of his profession to BIA-ALCL.
When considering BIA-ALCL, it’s vital you consider your options and do your research carefully. Not all surgeons are equal – or have the same level of expertise and experience.
How is BIA-ALCL Diagnosed?
If a patient develops a persistent fluid collection around an implant she should be investigated with ultrasound and if fluid is identified this will be removed and tested for BIA-ALCL
Specific tests are asked for using immunohistochemistry – specifically a concern regarding ALCL needs to be indicated and specific immunohistochemistry for CD 30 receptor protein (CD30+) and negative for anaplastic lymphoma kinase gene translocation (ALK-)
Most fluid collections will be benign seromas and not BIA-ALCL however it does need to be excluded
Mammogram is not useful
MRI and PET CT scans are performed to help stage the disease and plan surgery once a diagnosis is established
Are There Ways to Make Breast Implant Surgery Safer?
There is accumulating evidence that bacteria are associated with other complications of breast implant surgery as well
These include the risk for capsular contracture and acute infection, however neither of these lead to cancer.
Infection control standards are extremely important in breast surgery to ensure best outcomes and Plastic Surgeons are expertly trained to ensure the highest standards of patient care and low risk of infection.
Dr Dona has always adhered to strict principles of aseptic techniques specific to breast augmentation surgery for all his implant cases throughout his career. These steps have been demonstrated to also significantly reduce the incidence of capsular contracture.
