A rare condition, and a manageable one when found early
BIA-ALCL stands for breast implant-associated anaplastic large cell lymphoma. It is a rare type of lymphoma, a cancer of the immune system, that can develop in the scar tissue and fluid around a breast implant. It is not breast cancer.
Most cases are found at an early stage, when it is confined to the area around the implant, and treatment is often curative. Knowing the signs and having regular care is the best way to stay protected.
Why textured implants?
Nearly all confirmed cases have been linked to implants with a textured surface rather than a smooth one. Risk estimates vary by implant type and by country, and they are higher for some textured devices than others. Smooth implants have been associated with far fewer cases, and cases in people with only smooth implants are very rare.
The recalls
In 2019, after regulators identified a clear link between certain textured devices and a majority of reported BIA-ALCL cases, Allergan's BIOCELL textured breast implants and tissue expanders were recalled in many countries, including Canada. Some countries also restricted or removed other textured implants from the market.
If you are not sure what implants you have, you can find out. Your operative record or implant card lists the manufacturer, style and serial number, and your surgeon or the clinic that did your surgery can help. We can also help you find this information.
Symptoms to watch for
BIA-ALCL most often appears years after surgery, commonly after seven to ten years or more. The most common sign is a new collection of fluid, called a late seroma, around the implant. Signs to watch for include:
- Sudden swelling or enlargement of one breast, often after years of stable results
- A new lump in the breast or armpit
- Pain, redness or a change in breast shape or feel
- Hardening of the breast
Do not wait to get checked
These signs have many benign causes, but they should be checked promptly. If you notice any of them, contact your doctor or our clinic.
How it is diagnosed and treated
Diagnosis usually starts with an ultrasound, followed by sampling of the fluid for special testing. If BIA-ALCL is confirmed, the standard treatment is surgery to remove the implant together with the entire capsule, called total capsulectomy. When the disease is confined to the capsule, surgery is often all that is needed. Additional treatment may be needed in uncommon cases where it has spread, and it is coordinated with a cancer team.
Should everyone with textured implants have them removed?
For people with no symptoms, major health authorities have not recommended routine removal of textured implants, because the risk for an individual is low and surgery has its own risks. That said, many patients understandably prefer peace of mind, and that is a reasonable choice.
The right decision depends on your implant type, your age, your history and how you feel. We are happy to review it with you and to respect whichever option you choose.
Removal of textured implants at PEXY
Dr. Jaberi provides removal of textured implants, with capsulectomy, for people who have symptoms, who have recalled devices or who simply wish to switch. Depending on the situation, this may be done with a total or en bloc capsulectomy and may be combined with replacement, a breast lift or fat transfer.
Surgery carries risks, including bleeding, infection, scarring and changes in sensation or breast shape, and these are discussed in detail. You will leave your consultation with a clear plan and no pressure.