This information is intended to provide a general overview of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for any health concerns or before making any decisions related to your health.
Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare cancer of the immune system that develops in the fluid and tissue surrounding certain textured breast implants.
It is classified as a type of T-cell lymphoma. T-cells are specialised immune system cells that help activate the body's immune response and directly destroy disease cells. Lymphoma occurs when one of these T-cells mutates and begins to multiply uncontrollably.
While the tumour is found in the breast, BIA-ALCL is considered a form of lymphoma (a blood cancer), not a type of breast cancer.
It is a very uncommon disease; globally, fewer than 5,000 women have been diagnosed with BIA-ALCL to date.
Current evidence suggests the cancer is caused by chronic inflammation surrounding the textured surface of certain breast implants. These implants may have been placed for breast augmentation or for breast reconstruction following a mastectomy.
The disease is diagnosed exclusively in women who have textured breast implants. Implants with a rougher surface texture may carry an increased risk.
Most cases of BIA-ALCL develop between seven to ten years after the breast implant surgery.
Certain genetic changes, including those in the p53 and JAK genes, can also increase a woman's chance of developing BIA-ALCL.
BIA-ALCL generally responds well to treatment.
The five-year survival rate for BIA-ALCL is greater than 90%.
Patients who are diagnosed early in the disease's development typically have the best long-term outcomes.
BIA-ALCL can be challenging to diagnose because its symptoms may be similar to those caused by more common breast diseases and cancers. Symptoms can vary significantly among individuals.
A spontaneous collection of fluid (seroma) around the breast implant, developing many months or years after the implant surgery.
Unexplained swelling and redness of the breast surrounding the implant that is not due to an infection.
The affected breast may feel like a lump or a tight, tense, swollen area.
Contraction of the scar tissue capsule surrounding the breast implant (capsular contracture).
Women with a textured breast implant who experience any unexplained symptoms of BIA-ALCL should see a doctor right away. Other serious conditions with similar symptoms that require medical attention include:
Women with textured breast implants should perform regular breast self-examinations. Any unexplained lumps or breast asymmetry should be reported to a doctor immediately.
In addition to regular breast cancer screening, women at risk for BIA-ALCL should undergo routine breast implant surveillance. This typically involves a breast MRI or ultrasound five years after the implant surgery, followed by a check every three years thereafter.
As with all cancers, Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is easiest to treat when detected early. Diagnosis is often difficult due to the disease's rarity and the similarity of its symptoms to other common breast conditions. It is crucial to be diagnosed by a medical team with experience in treating this specific disease.
If BIA-ALCL is suspected, your doctor will perform a physical examination and take a detailed medical and lifestyle history, including questions about breast implants and previous breast surgeries.
This is the only definitive way to diagnose BIA-ALCL. A small tissue sample is removed and examined under a microscope for cancer cells. Depending on the tumour's location, a biopsy may be performed on an outpatient basis with local anaesthesia, or a surgical biopsy requiring general anaesthesia may be necessary.
These are used to locate tumours inside the body and track treatment response. Imaging exams for BIA-ALCL include:
These help monitor the cancer and the patient's overall health during the course of treatment.
This process identifies the specific features of the cancer cells at the molecular level, which can influence and help doctors formulate the most effective treatment plan.
Patients may undergo genetic testing to better understand their cancer, particularly if certain genetic mutations are present which increase the risk of developing the disease.
Treatment for BIA-ALCL at SSCHRC focuses on tumour removal, breast restoration, and the patient's quality of life. Treatment plans utilise specialised, often less-invasive, surgical techniques alongside other therapies.
Many patients only require surgery for successful treatment. Others may need targeted therapy, and patients with more aggressive cancers may be treated with additional options such as chemotherapy, radiation therapy, and stem cell transplantation.
The main surgical objective is to remove the cancer and any surrounding tissue that could cause the cancer to grow. Surgeries for BIA-ALCL include:
IRTC is performed under general anaesthesia, typically lasting about three hours. Patients usually spend one night in the hospital and can often walk a few hours after the procedure. Normal activities can usually be resumed about a week after surgery, with full recovery taking two to three weeks.
These drugs are designed to interfere with specific molecules (often proteins) that cancer cells need to survive, multiply, and spread. They are administered through an intravenous (IV) infusion, typically every three weeks for a total of four to twelve sessions. The most common side effect for BIA-ALCL patients is neuropathy (nerve damage) which can cause pain, tingling, or weakness.
Chemotherapy drugs kill cancer cells, control their growth, or relieve disease-related symptoms. Treatment may involve a single drug or a combination of two or more, depending on the cancer's type and growth rate. It is given through an IV infusion, usually two to three times a week for six to eight weeks, though treatment plans vary. Side effects depend on the specific drug but can include hair loss, nausea, fatigue, and increased risk of infection.
This uses powerful, focused beams of energy (usually X-rays) to destroy cancer cells. It can be given after surgery to eliminate any remaining cancer cells or used when a patient cannot undergo surgery. Patients typically receive treatment three times a week for three weeks, with each session lasting about 30 minutes. Side effects include fatigue and skin irritation (itchy, dry, or red skin).
This procedure replaces cancerous bone marrow with new, healthy stem cells. For BIA-ALCL, the healthy stem cells are taken from the patient (autologous stem cell transplant), not a donor. It is typically administered after an intense round of chemotherapy or radiation to kill existing bone marrow cells. Patients usually stay in the hospital for three to four weeks after the transplant. Stem cell transplants are rarely used for BIA-ALCL and are generally reserved for patients with the most advanced and aggressive forms of the disease.