What is BIA-ALCL?
It’s estimated that between 5 and 10 million women have breast implants. Since the initial MHRA medical device alert in the UK in 2011 only fourteen cases of Anaplastic Large Cell Lymphoma (ALCL) have been reported (correct at March 2016). Due to the rarity of a diagnosis of ALCL (believed to be in the order of 1:50,000-300,000) a worldwide collaboration is required to provide robust data to investigate the link. This need reinforces BAPRAS’ commitment to the International Collaboration on Breast Registry Activities (ICOBRA).
BIA-ALCL is a lymphoma and not cancer of the breast tissue. When breast implants are placed in the body, they are inserted behind the breast tissue or under the chest muscle. Over time, a fibrous scar called a capsule develops around the implant, separating it from the rest of the breast. In women with breast implants, the ALCL was generally found adjacent to the implant itself and contained within the fibrous capsule. BIA-ALCL presets with late onset (>1year post implantation), rapid swelling of one breast and it is diagnosed on cytology of the periprosthetic fluid and the CD30 cell count in particular.
BIA-ALCL appears to be related to textured breast implants and it appears to have occurred with textured implants made by every manufacturer. International collation of these cases should allow more information on these links in coming months and years.
‘Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients’ (reference 1) concluded that: “most patients with breast implant-associated ALCL, who had disease confined within the fibrous capsule achieved complete remission. Proper management for these patients may be limited to capsulectomy and implant removal. Patients who present with a mass have a more aggressive clinical course that may be fatal, justifying cytotoxic chemotherapy in addition to removal of implants.”
Information supplied via BAPRAS.
