ALCL – rare type of cancer

You may have read recently in the media about the prevalence of ALCL (large cell lymphoma of the breast) and its association with breast implants. Note that at this stage, it is thought to be an association and not a causation ie that implants haven’t yet been shown to cause ALCL.

The Plastic Surgery community have known about this for at least the last 2 years and data continues to be collected with The National Breast Device Registry.

ALCL occurs in the general population but is much more likely in the breast implant population. It presents on average 8-10 years after implantation as an unexplained seroma or fluid collection. To diagnose it one needs to aspirate some fluid and perform special cytologic tests on the fluid. About 300 cases worldwide have been reported so far but it is probably under reported.

The postulated cause is thought to be a complicated mechanism involving bacterial biofilm attaching to the breast implant with an immunological deficiency triggering the ALCL.

Some facts we do know so far;

ALCL is a type of cancer. It is rare however with a prevalence of 1 in 30,000 breast implants recently published. The majority present as a fluid collection only with no mass detected on MRI. The majority of these respond well to treatment, which is usually removal of the implant and surrounding capsule.

ALCL has never been associated with smooth implants. No one manufacturer is immune from ALCL but macro textured implants are more likely to be implicated than micro or nano textured implants.

If you have breast implants you should not be unduly concerned. You should only get concerned if you develop an unusual swelling of your breast. Have your GP arrange an Ultrasound and if there is any free fluid they can aspirate this and send it off to the laboratory for special testing. You should then make an appointment to see your Plastic Surgeon.

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