Learn More About Potential Bia
If you have been diagnosed with BIA-ALCL or believe that you are at risk after a breast implant surgery, you can get help. Visit our website and we can provide you with a free case review. Our team can help you understand which breast implants pose a medical risk, and which medical and legal options are available to those affected.
You dont have to go through this process on your own. Contact us for a free case review today.
Discuss Your Goals With Southern Plastic & Reconstructive Surgical Institute
Dr. Brought and the staff at SPRSI take pride in our customer service and compassionate care. We take action to protect our patients from risk, offering full transparency that allows you to make an educated decision on the best method to reach your desired shape. We dont use an answering service instead, we remain available day and night for our patients needs.
We offer a holistic approach to health and wellness in a range of cosmetic and reconstructive procedures, including breast augmentation. During your appointment, we will discuss your goals and the best plan of action to achieve them. Not everyone is suitable for every procedure, but we will do our best to provide safe alternatives to give you the confidence you deserve.
Fact Check: Do Breast Implants Increase The Risk Of Cancer
Most who undergo breast implant surgery whether it be for cosmetic or reconstructive reasons do not experience any long-term side effects, but the rumors of the relationship between breast implants and cancer may cause concern for women.
According to Dr. Jennifer Manders, a breast surgeon for The Christ Hospital, research has shown that implants do not increase a womans risk of breast cancer. However, those with implants should be aware that it might be hard for the doctor to see certain parts of the breast when conducting a mammogram, which should still be done regularly.
Implants can make it hard to look at every single piece of the breast on mammography, so sometimes we have to use special displacement views and it can be a little uncomfortable for the patient, she said.
Manders also said theres a lot of buzz currently about textured implants and lymphoma. According to the FDA, all the information to date suggests that women with these breast implants have a very low, but increased risk of developing anaplastic large-cell lymphoma compared to women who do not have breast implants. According to Manders, if you have these breast implants, these findings are not a call to change your treatment plan or to have your breast implants removed.
Manders suggests getting in touch with your doctor right away if you experience pain or discomfort or other concerning changes such as swelling or lumps in your breasts.
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What Is Breast Implant Associated Cancer
Breast implant associated cancer, which is also known as breast implant associated anaplastic large cell lymphoma , is a rare cancer of the immune system. It is not breast cancer, which forms from cells in the breast, but instead a cancer that grows in the fluid and scar tissue that forms around a breast implant. Less commonly, BIA-ALCL can take the form of a lump in the breast or a lump in the armpit.
BIA-ALCL has been known to occur as soon as one year after the operation and as late as 37 years after the operation. The average time to diagnosis is within 8 years of the operation.
Expect To Have Extra Images Taken
The standard mammogram is two views of each breasta total of four pictures. But women with breast implants typically require a couple of additional views of each breast. The extra views are gathered to detect cancers that might be obscured by the implants.
Theyre called implant displacement views, says Dr. Patel, a member of the National Comprehensive Cancer Networks Guidelines Panel for Breast Cancer.
The breast is drawn out, pushing the implant toward the chest wall so more of the breast tissue is visualized with the mammogram, he explains.
Implant displacement views involve relatively little compression, just enough to keep the breast still, Dr. Baker notes.
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What Kinds Of Surgery Can Reduce The Risk Of Breast Cancer
Two kinds of surgery can be performed to reduce the risk of breast cancer in a woman who has never been diagnosed with breast cancer but is known to be at very high risk of the disease.
A woman can be at very high risk of developing breast cancer if she has a strong family history of breast and/or ovarian cancer, a deleterious mutation in the BRCA1 gene or the BRCA2 gene, or a high-penetrancemutation in one of several other genes associated with breast cancer risk, such as TP53 or PTEN.
The most common risk-reducing surgery is bilateral prophylactic mastectomy . Bilateral prophylactic mastectomy may involve complete removal of both breasts, including the nipples , or it may involve removal of as much breast tissue as possible while leaving the nipples intact . Subcutaneous mastectomies preserve the nipple and allow for more natural-looking breasts if a woman chooses to have breast reconstruction surgery afterward. However, total mastectomy provides the greatest breast cancer risk reduction because more breast tissue is removed in this procedure than in a subcutaneous mastectomy .
Even with total mastectomy, not all breast tissue that may be at risk of becoming cancerous in the future can be removed. The chest wall, which is not typically removed during a mastectomy, may contain some breast tissue, and breast tissue can sometimes be found in the armpit, above the collarbone, and as far down as the abdomenâand it is impossible for a surgeon to remove all of this tissue.
What Are Breast Implants
Breast implants are gel or fluid-filled pouches inserted in the breast area. People may get breast implants for many reasons, including cosmetic enhancement or reconstruction after breast surgery.
Breast implants differ in their size, shape, filling and surface characteristics. Most implants are either round or teardrop-shaped. They may be filled with saline or with silicone gel. The surface of the implant may be smooth or rough and different implants may vary in the amount of irregularity of the texture.
Breast implants are not lifetime devices and need to be replaced after 10 to 15 years.
If you are considering breast implants, read our page that covers things you should know before undergoing the procedure.
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Implants Can Hide Breast Cancer On A Screening Mammogram
The X-rays used in mammograms dont sufficiently penetrate saline or silicone. So, depending on where a cancer is located, it can be tougher to find on a mammogram.
It is manageable we do it all the time, it definitely makes things a little trickier, Dr. Baker says.
In the same Plastic and Reconstructive Surgery study above, the rate of cancer detection by screening mammography was actually lower for women with implants versus women without implants .
Despite the limitations of mammography screening in women with implants, Dr. Patel says their survival is no different: The outcome in patients that do develop breast cancer, even with implants, is the same as those without implants.
Things To Think About Before Getting Implants
Most women will do well with implants. But there are some important factors to keep in mind if you are thinking about having implants to reconstruct the breast and/or to make the other breast match the reconstructed one:
- You may need more surgery to remove and/or replace your implant later. In fact, up to half of implants used for breast reconstruction have to be removed, modified, or replaced within 10 years.
- You might have problems with breast implants. They can break or cause infection or pain. Scar tissue may form around the implant , which can make the breast harden or change shape, so that it no longer looks or feels like it did just after surgery. Most of these problems can be fixed with surgery, but others might not.
- Breast MRIs may be needed every few years to make sure silicone gel implants have not broken. Your health insurance might not cover this.
- Routine mammograms to check your remaining breast for cancer could be harder if you have a breast implant there you may need more x-rays of the breast, and the compression may be more uncomfortable.
- An implant in the remaining breast could affect your ability to breastfeed, either by reducing the amount of milk or stopping your body from making milk.
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Breast Implants And Anaplastic Large Cell Lymphoma
Dr. Jones: So what did the FDA identify as a possible association between breast implants and a rare non-breast cancer?
Dr. Agarwal: Over the past decade and a half, the FDA, the medical societies, and doctors in general have been paying very close attention to the outcomes of their patients that have had breast implants placed. And so, over the past number of years, we found that there is a very small but significant incidence of a rare lymphoma, and it appears that it’s associated with a specific type of breast implant, whether they’re placed for reconstructive purposes or cosmetic reasons. And that’s ALCL, an anaplastic large cell lymphoma.
Dr. Jones: That’s a new one to me.
Dr. Agarwal: Yeah. Most people haven’t heard it.
Dr. Jones: Right. Very rare.
Dr. Agarwal: And it’s not a breast cancer as we think of breast cancers. It is a lymphoma. It’s typically found in the capsule, the scar tissue that surrounds a breast implant. But again, I want to emphasize that it’s exceedingly rare.
Dr. Jones: If there’s an increased risk, what kind of numbers are we talking about?
Dr. Agarwal: We’re talking about really low risk. It appears that patients with breast implants have about a one in 3,800 to one in 30,000 risk of developing this type of lymphoma. To put that in a broader context, you can think that the average woman in the United States, one in eight women will develop breast cancer.
Dr. Jones: In their lifetime, yeah.
Dr. Agarwal: That’s correct.
How Do Implants Cause Cancer
Exactly how breast implants might cause ALCL is not known. It’s possible that chronic inflammation around the breast triggered either by the implant itself or bacteria that adhere to the surface of the implant may play a role, the researchers said.
Patients with ALCL in the breast usually fare well if the disease is caught early. Of the 32 patients with ALCL tied to breast implants in the study, 90 percent were in complete remission after about three years.
For this reason, it’s important that women considering breast implants be aware of the symptoms of ALCL, the researcher said. Symptoms can include persistent swelling or pain in the area of the breast implant, according to the FDA. These symptoms often occur many years or decades after the breast implant surgery.
The study was published in the Jan. 4 issue of the journal JAMA Oncology.
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Factors That Do Not Increase Breast Cancer Risk
Many factors have been studied to see whether or not they increase the risk of breast cancer.
Some of these factors have been proven to be unrelated to breast cancer and dont increase risk. Some may even decrease risk .
A full list of factors that dont increase breast cancer risk is too long to present here. Some, however, deserve mention because theyve been studied more than most or theyve gotten a lot of media attention.
Our Breast Cancer Risk Factors Table compares these and other factors by level of risk and strength of evidence.
The factors below are listed alphabetically.
Research clearly shows no link between abortion and the risk of breast cancer .
Since 2003, the American College of Obstetricians and Gynecologists and the National Cancer Institute have agreed the scientific evidence does not support a link between abortion and breast cancer . The ACOG reaffirmed its conclusion in 2019 that theres no link between abortion and breast cancer .
Implant Rupture With Mammography Is Rare
Worried that your implant might burst under compression? Its not a common occurrence.
A 2004 study in the Journal of Womens Health examined problems with mammography for women with breast implants. When researchers reviewed adverse events reported to the U.S. Food and Drug Administration , they identified just 44 incidents involving breast implant rupture with mammography.
In a separate review of published studies, FDA researchers identified another 17 cases involving breast implant rupture during compression.
Yet there are almost 300,000 women who undergo breast augmentation each year, says the American Society of Plastic Surgeons.
In many rupture cases, Dr. Baker suspects the implant was already compromised and the compression just helped it along.
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Always Inform The Scheduler And Mammogram Technologist
If you have implants, say so. Tell the scheduler when you make an appointment for your mammogram. Make sure the staff has experience screening women with implants. And give the mammogram tech a heads up before your imaging procedure begins.
The technologist needs to know two things, Dr. Baker says. One is how to position her. There are extra steps involved in screening a woman with implants . The other is how much compression to use.
According to the Radiological Society of North America , an experienced technologist will know how to carefully compress the breasts of women with implants without risking rupture.
Should You Consider Getting Breast Implants
If youre considering getting breast implants, schedule an appointment with an experienced surgeon to discuss your goals. You shouldnt have to live your life with insecurities, and you deserve to feel confident about your shape. As previously mentioned, your surgeon will discuss the benefits and risks associated with breast implants.
They will walk you through each step, from the safest types of breast implants, what to expect, how to monitor for complications, and your options for eventual removal or replacement if necessary. Ultimately, your surgeons goal is to make you feel confident in your body in the safest way possible.
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Risks Of Breast Implants
Certain types of breast implants can be linked to a rare kind of cancer, known as anaplastic large cell lymphoma . It is sometimes referred to as breast implant-associated anaplastic large cell lymphoma . It is not a type of breast cancer. This lymphoma happens around 8 to 10 years after the implant was placed and more often if the implants have textured surfaces rather than smooth surfaces. If BIA-ALCL does show up after an implant, it can show as a collection of fluid near the implant, a lump, pain, swelling or asymmetry . If you have any concerning symptoms, you should discuss them with your doctor.
Early-stage disease is often treated with surgery to remove the implant and capsule. More advanced disease requires chemotherapy. Radiation may be used in certain cases. Prognosis is usually better for women with early-stage disease.
Improving Informed Consent: Learning About Risks Before Surgery
If youre considering breast implant surgery or any other kind of medical procedure your surgeon is supposed to make sure that you understand the risks, benefits, and alternative treatment options so you can make an informed decision. State and federal laws specify some of what is supposed to happen as part of this process, which is known as informed consent.
Ideally, informed consent involves having an open discussion with your surgeon, being able to ask questions, and receiving written information about risks thats easy to understand. This should take place before youve paid a nonrefundable deposit for the procedure. If you decide to move forward with the surgery, you sign an informed consent form, acknowledging that youve been given the information you need and that youre agreeing to the surgery.
However, not all plastic surgeons handle informed consent in the same way. Some devote more time to discussing potential risks with patients and give patients more information about risks than others. Sometimes the risk of conditions like BIA-ALCL and BII doesnt get discussed at all.
When Lory DAddario got reconstruction with Mentor textured implants in 2015, the link between breast implants and BIA-ALCL had already been identified. The FDA, the National Comprehensive Cancer Network, and the American Society of Plastic Surgeons had been publishing information about BIA-ALCL for a few years. However, DAddario says her plastic surgeon did not mention this risk.
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Have You Been Diagnosed With Bia
Receiving the diagnosis of BIA-ALCL may cause anxiety and frustration but women should know that not all cancers are equal. When caught early, BIA-ALCL is curable in most patients.
ASPS endorses BIA-ALCL guidelines established by the National Comprehensive Center Network , which defines diagnosis and treatment based on proven methods to treat the disease.
Preventative Measures Before Breast Surgery
I think you want to ask all the right questions as a patient. What type of implant am I having placed? What are the risks of the surgery? What are the risks of the implant?
From the physician side, it’s important to do a full physical exam when your patient comes in for their annual visit. That includes a full breast exam, particularly in patients who have had breast implants. If a patient notices anything suspicious or a change in the shape, size, or feel of their breast, they should bring it to the attention of their physician. And if an OB/GYN or a family practice doc has concerns, they should then have the plastic surgeon involved.
The FDA at this point recommends that either an ultrasound or an MRI can be done as a screening tool. Anyone who has symptoms should go directly to MRI. Anyone who has an implant placed, particularly a textured implant, should have a screening MRI after five or six years after the implant was placed.
Dr. Jones: Well, for many women who are making the choice about breast implants, only they will be able to balance the risks and benefits in their own bodies. But we try to give them the best information that we have and help support them with their decision. Thanks, Dr. Agarwal, and thanks for joining us on The Scope.
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