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Breast Implants and Lymphoma: Where's the Connection?

Posted: 04/14/11 07:29 AM ET

Based on anecdotal data, false claims and unfounded science, the safety of silicone-filled breast implants was questioned in the 1990s. This resulted in an epidemic of patient anxiety, unnecessary implant removals, litigation, and an almost 20-year FDA imposed moratorium on their use.

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However, laboratory and clinical studies conducted by plastic surgeons, together with the industry, have since demonstrated the safety of silicone breast implants. These findings prompted the FDA to once again approve silicone implants for breast reconstruction and breast enhancement only a few years ago.

Yet on January 26, 2011, the FDA announced a possible association between breast implants and a type of cancer - anaplastic large cell lymphoma (ALCL).

ALCL is a rare cancer of the immune system, which can occur anywhere in the body. Only one in 500,000 women in the U.S. is diagnosed with ALCL every year. In a thorough review of scientific literature published from January 1997 through May 2010, the FDA identified 34 unique cases of ALCL in women with breast implants throughout the world.

According to the American Society of Plastic Surgeons, nearly four million breast implant procedures were performed in the United States from 1998 to 2009. The total number of implants worldwide is estimated to be between 5-10 million. That means that ACLC in women with breast implants is an extremely rare occurrence.

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. The typical sign of this problem was swelling around the implant years after surgery, due to accumulation of fluid between the capsule and the implant.

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The ALCL in patients with breast implants has demonstrated an indolent course -- or one that is relatively inactive. In most cases treatment consisted of removing the capsule and the implant. Although lymphoma in patients with implants technically fulfills the criteria for classification as ALCL, it may represent a distinct form of disease.

The FDA believes that women with breast implants may have a very small but increased risk of developing lymphoma in the scar capsule adjacent to the breast implant. Yet the FDA also states that the evidence continues to support a reasonable assurance that FDA-approved breast implants are safe and effective when used as labeled.

The FDA does not recommend removal of breast implants and women with implants should continue their normal self exam, and mammography when appropriate. They should report any changes to their plastic surgeon.

The FDA is collaborating with the American Society of Plastic Surgeons to establish a registry of patients with breast implants who have been diagnosed with ALCL. This collaboration, as well as the collection of relevant objective data will hopefully ensure that science rather than hysteria will form the basis for decision making regarding the safety and use of breast implants.

 
 
 
Based on anecdotal data, false claims and unfounded science, the safety of silicone-filled breast implants was questioned in the 1990s. This resulted in an epidemic of patient anxiety, unnecessary imp...
Based on anecdotal data, false claims and unfounded science, the safety of silicone-filled breast implants was questioned in the 1990s. This resulted in an epidemic of patient anxiety, unnecessary imp...
 
 
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alongst
too often denied to speak
06:51 PM on 04/14/2011
Within two minutes of this story being posted, several lawyer firms from New York already had television ads out asking "If you or someone you love has ever had a breast implant..."....
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HUFFPOST SUPER USER
Sharon Hanson
Skeptical of the *pseudo-skeptics*
05:22 PM on 04/14/2011
Doesn't mold and bacteria grow on these implants? That's enough to make anyone sick.
04:38 PM on 04/14/2011
No idea if they cause lymphoma, but they do cause 80yo women to have boobs sticking right up and that's just wrong. I want to die with my boobs sagging the way nature intended it all along.
02:44 AM on 04/18/2011
LOL..but you are right..
OverseasVet
stuck in a 3rd world country called texas
02:19 PM on 04/14/2011
A scare article based on only 34 cases worldwide?
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alongst
too often denied to speak
06:52 PM on 04/14/2011
It's how the lawyers work......
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Halsey
"There is a price to pay for speaking the truth. T
01:42 PM on 04/14/2011
What are thy symptoms, aside from swelling which may happen anyway, for ALCL?
I had wonderful implants 20 years ago; ever (after initial recovery pain which WAS intense) a problem. I loved them. Sadly a head-on with a teenager, wherein my chest hit the steering column, exploded my implants. I didn't have airbags, so who knows, maybe the implants saved my life. BUT (and I didn't have money to have them replaced and the teen was, of course, NOT insured), 15 years later I did get breast cancer (triple negative). I've never blamed the implants for this bad luck. Truly. Triple-negative is a strange beast of cancer.
I'm still curious about symptoms. As far as I know (from MRI's, etc) my breasts are cancer free, but I NEVER, EVER feel okay. I don't want to get all paranoid (and frankly if I had money, I'd get implants to at least made my breasts the same small size..insurance did NOT cover reconstructive, so I'm deformed). Back to curiosity, however. Symptoms please.
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HUFFPOST SUPER USER
Sharon Hanson
Skeptical of the *pseudo-skeptics*
05:21 PM on 04/14/2011
Halsey I got MRIs due to high risk for breast cancer. The gadolinium based contrasting agents they inject in you during these exams makes you very ill. Omniscan (GE's product) and Magnevist (Bayer's product) are the worst of all of them but most are now on the FDA warning list. Of the doses they inject 1% of this toxic heavy metal stays in the body. Look up Nephrogenic Systemic Fibrosis to see what this heavy metal does to people. You do not need to have the skin condition and you do not have to have kidney disease to get this disease.
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Halsey
"There is a price to pay for speaking the truth. T
09:49 PM on 04/14/2011
Thank you for your thoughtful reply. I so googled, wikepedia'd this disease and don't see my symptoms there. If you have a specific link, I'd appreciate it.

I AM sorry you are high risk for Breast cancer (I assume the gene). My breast cancer was different; rare, non-hormonal, not hereditary. Please continue to take care of yourself and while I am not remotely a doctor, I am the point where I want thermal imagine (instead of MRI's and mammograms) to check if mine comes back.
Frankly, trip-neg likes to return via brain or bones; not a recurrance in the breasts, but I STILL want thermal (zero radation and not the pain of a mammogram, which after surgery and radiation is very very painful).
Of course, even my sweet oncologist wants to stick with the "standard" so my fight is to get my insurance, while I still have it, to cover thermal.
I'm fanning you, we are sisters in this.!
10:47 AM on 04/14/2011
A good reminder to do your research, weigh your options and question your doctor. Here's a video that gives some tips: http://whatstherealcost.org/video.php?post=five-questions