ALCL Information

Since 2012 there has been an increasing awareness in relation to the presence of a rare lymphoma associated with breast implants, breast implant-associated anaplastic large cell lymphoma. Commonly referred to as BIA-ALCL.

BIA-ALCL 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.

A/Prof Magnusson was instrumental in commencing landmark research in Australia and New Zealand into the incidence of this problem and with a collaborative group of other surgeons, haematologists and researchers that generated transformative research that gave us the best indication of risk associated with different implant types (see references below).

The implants with the greatest association with BIA-ALCL were found to be those with textured surfaces. There is no clear evidence that patients only exposed to smooth breast implants have developed this condition. All varieties of textured breast implants used in Australia have been associated with this condition.

This research has been used in multiple forums by regulators in Europe, the United States and Australia. A/Prof Magnusson sits on an Expert Working Group for the Therapeutic Goods Administration (TGA), the Australian Government’s regulatory body, which moved to withdraw eight varieties of textured breast implant from the Australian market and another implant style produced by Allergan was voluntarily withdrawn by the company thereby reducing the risk of this problem moving forward.

The implants withdrawn from the market were not “recalled” like we have seen with airbags in motor vehicles that needed to be removed and reinstalled with a different model. Even if your breast implants are being cancelled or suspended, medical experts do not recommend removing them if you do not have symptoms of BIA-ALCL. This is because BIA-ALCL is rare, and the risk of undergoing surgery could be higher than the risk of developing BIA-ALCL.

Patients of A/Prof Magnusson’s may have implants implicated developed by Silimed (polyurethane implants/“furry Brazilian”), Allergan Biocell textured silicone implants (round or shaped) and Mentor Siltex silicone implants (round or shaped).

It is important to know the symptoms of BIA-ALCL. The most common symptom is swelling of a breast caused by fluid build-up around the implant called a seroma, but in some cases it may appear as a lump in the breast or armpit.

As this is a rare disease, changes in your breast are not likely to be breast implant associated lymphoma. For example, swelling immediately after your breast implant surgery is normal. But you should contact our clinic or your GP. The best initial investigation is an ultrasound scan of the breast implants to look for rupture and particularly the presence of fluid around the implant (seroma).

If you are a patient of A/Prof Magnusson’s and have questions about your implants or further questions about BIA-ALCL please reach out to the clinic on 1300 662 960 or via email enquiries@drmagnusson.com.au.

With so many people giving advice or thoughts about medical problems online, on social media platforms or in the print media it can be hard to get unbiased information. The best source of information is the Australian Government’s own advice from the TGA. https://www.tga.gov.au/breast-implant-associated-cancer-or-bia-alcl

References:

• Anna Loch-Wilkinson, Kenneth J. Beath, Robert John William Knight, William Louis Fick Wessels, Mark Magnusson, Tim Papadopoulos, Tony Connell, Julian Lofts, Michelle Locke, Ingrid Hopper, Rodney Cooter, Karen Vickery, Preeti Avinash Joshi, H. Miles Prince and Anand K. Deva. Breast Implant–Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand. Plast Reconstr Surg 140, 645–654 (2017).
• William P. Adams, Eric J. Culbertson, Anand K. Deva, Mark R. Magnusson, Craig Layt. Macrotextured Breast Implants with Defined Steps to Minimize Bacterial Contamination around the Device. Plast Reconstr Surg 140, 427–431 (2017).
• Mark Magnusson, Kenneth Beath, Rodney Cooter, Michelle Locke, H Miles Prince, Elisabeth Elder, Anand K Deva. (2019). SPECIAL UPDATE: The epidemiology of Breast Implant Associated Large Cell Lymphoma in Australia and New Zealand confirms the highest risk for grade 4 surface breast implants. Plast Reconst Surg. 2019;143(5):1285-1292 doi: 10.1097/PRS.0000000000005500
• David J Collett, Hinne Rakhorst, Peter Lennox, Mark Magnusson, Rodney Cooter, Anand K Deva. (2019). Current Risk Estimate of Breast Implant–Associated Anaplastic Large Cell Lymphoma in Textured Breast Implants. Plastic and Reconstructive Surgery. 143(3S):30S-40S, March 2019. doi: 10.1097/PRS.0000000000005567
• Anna Loch-Wilkinson, Kenneth J Beath, Mark R Magnusson, Rodney Cooter, Karen Shaw, James French,Karen Vickery,H Miles Prince, Anand K Deva. Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia: A Longitudinal Study of Implant and Other Related Risk Factors. Aesthet Surg J 40, 838–846 (2019).
• Mark Magnusson. Commentary on: Comparative Analysis of Cytokines of Tumor Cell Lines, Malignant and Benign Effusions Around Breast Implants. Aesthet Surg J. 2019;128(3):651. doi:10.1093/asj/sjz267.
• Anand K Deva, Suzanne D Turner, Marshall E Kadin, Mark R Magnusson, H Miles Prince, Roberto N Miranda, Giorgio G Inghirami, William P Adams Jr.  Etiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL): Current Directions in Research. Cancers 12, 3861–14 (2020).
• Mark Magnusson. Commentary on: Is Banning Texturized Implants to Prevent Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) a Rational Decision? A Meta-Analysis and Cost-Effectiveness Study. Aesthet Surg J. 2020;40(7):735-739. doi:10.1093/asj/sjaa022.