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Breast Implants and ALCL

A Blog on an Unusual Type of Cancer by Dr. Loftus

On January 26, 2011 the FDA released preliminary findings suggesting a possible link between breast implants and a very rare form of lymphoma, called ALCL (Anaplastic Large Cell Lymphoma).


The FDA has found 34 individual cases described in medical literature suggesting an association between ALCL and breast implants. There was no clear difference in the likelihood of saline or silicone implants to be associated with these cases of ALCL. Five to ten million women are estimated to have breast implants. The number of cases is so small that they cannot determine with statistical significance if there is truly a link between ALCL and breast implants or if it is coincidence. In other words, it is possible that women with breast implants and women without breasts implants have the same risk of developing ALCL, and that breast implants themselves did not contribute to the development of ALCL in these 34 women.

The cases involve women who had implants for reconstructive and cosmetic purposes. The cases include women with silicone and saline implants, textured and smooth. The tumors seem to have developed in the scar tissue capsule around the implants of the affected women, not in the breast tissue, itself. ALCL is not breast cancer- it is a cancer of the immune system. Many of the women were diagnosed when a fluid collection formed around their implant years after surgery. Some women felt a lump near the implant. This occurred on average 8 years after surgery. ALCL can occur in other places around the body and occurs in people without breast implants. However, it is the close association between the implant capsule and lymphoma in these 34 cases that creates the concern for a link between implants and ALCL. The reports suggest that this may be a less-aggressive form of lymphoma. Reassuring also is the fact that available data on treated women suggests the ALCL which occurs in the area of the implant capsule was treated successfully resulting in cure.


The chance of you developing ALCL is extremely small, and you could develop it whether or not you have breast implants. It is impossible to know if there is truly a link between ALCL and breast implants at this time, but it is important for the medical community to be vigilant. The FDA will continue to monitor for cases of ALCL and doctors will report any cases as they arise. The FDA report states, "ALCL is so rare, even in breast implant patients, a definitive study would need to collect data on hundreds of thousands of women for more than 10 years. Even then, causality may not be conclusively established."

What should you do if you have breast implants?

First, you do not need to have your implants removed. The FDA stated that current evidence continues to support that breast implants are safe. There does not seem to be an increased risk of ALCL with any particular implant type. In other words, women with both silicone implants and saline implants developed ALCL – as have women without implants. The fact that women with any type of implant have developed ALCL has lead some to speculate that the implants themselves did not contribute to the development of ALCL. Since ALCL is so rare and seems to be diagnosed due to the presence of fluid collections or atypical lumps, additional screening tests are not going to be beneficial. In a sense, nothing changes for you. You should continue doing monthly self-breast exams. If there is a change, you should get it checked out. You should have annual breast exams by your physician and continue with annual mammograms starting at the age of 40, unless otherwise directed by your physician. Read more about breast implants and mammograms. If you develop a fluid collection around an implant years after surgery, the fluid should be sampled and sent to a lab to check for ALCL. Also, if you develop significant capsular contracture, the capsule should be sent to the pathology lab to check for ALCL after it is removed in surgery if there is an associated mass or fluid collection.

What should you do if you are considering breast augmentation?

Breast implants have safely provided many women with improved quality of life through cosmetic augmentation. The 34 cases of ALCL in women with breast implants may or may not ultimately prove to be associated; however, if there proves to be an association, the increased risk of ALCL to women with breast implants remains extremely small. By comparison, your risk of a serious motor vehicle accident remains much higher. We may not know if there is any true association between breast implants and ALCL for at least 10 – 15 years. The FDA’s continued endorsement of breast implant safety is very reassuring. You should always consider the risks and benefits of any procedure and discuss your particular circumstances with your plastic surgeon.

Dr. Loftus

About Dr. Loftus

Dr. Loftus is a female plastic surgeon who is considered a national authority on plastic surgery, having appeared on numerous talk shows as an expert. Her book has become a best-selling book on plastic surgery and has earned her the reputation as a vocal advocate of patient safety, satisfaction, and education in plastic surgery. No wonder her patients have such great things to say about her…
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