Breast implant associated squamous cell carcinoma and other lymphomas
BIA-ALCL
Breast implant associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of lymphoma that has been reported in women with a textured breast implant device. It is a cancer of the immune system, not a type of breast cancer. When identified early, it may be curable in most patients.
BIA-SCC and other lymphomas
On 20 September 2022, the Australian Therapeutic Goods Administration (TGA) issued a Safety Alert about reports of squamous cell carcinoma (SCC) and various lymphomas located in the capsule or scar tissue around breast implants. The reports of cancers in the capsule around breast implants are different to BIA-ALCL.
Signs and symptoms
All women with or without breast implants should regularly perform thorough self-examinations of their breasts in line with recommended guidelines.
The most common symptom of BIA-ALCL is swelling of the breast. It can also present as a lump in the breast or in the armpit.
Symptoms associated with BIA-SCC and other lymphomas in the capsule or scar tissue around the breast implant can include swelling, pain, lumps, or skin changes.
If you think there are any changes in your breast or implants, or if you have any concerns, consult your general practitioner (GP) or treating Specialist/Surgeon who will undertake the required tests. Testing is only recommended if you are experiencing symptoms.
Please note: it is normal to have some breast swelling for a period of time after your breast implant operation, and your doctor will advise how long this swelling should be expected.
Cause
Women at risk of BIA-ALCL
There are various types of breast implants. The TGA, the Australian Government Department responsible for regulating medical devices, has investigated the association between breast implants and BIA-ALCL. The TGA have found:
- the risk of developing BIA-ALCL is rare
- the risk of developing BIA-ALCL is associated with the type of breast implants. The rougher and more textured the implant, the higher the risk appears to be
- at the time of publishing, there has not been a documented case of BIA-ALCL in a patient with only smooth implants.
Breast implants with a higher risk of BIA-ALCL have been removed from the Australian market. In addition, some suppliers have also decided to remove particular types of breast implants from the market. For up-to-date information on which breast implants and tissue expanders are affected please visit the Breast implants and anaplastic large cell lymphoma alert on the TGA website.
Women at risk of BIA-SCC and other lymphomas
The risk of developing BIA-SCC and other lymphomas appears to be extremely rare, and there is insufficient information to say whether breast implants cause these cancers or if some implants (smooth or textured, saline or silicone) pose higher risk than others.
The TGA is monitoring the occurrence of the disease in Australia and is in communication with other international regulators and Australian experts. As at 14 September 2022, the TGA is not aware of any cases of BIA-SCC in Australia. Information on the issue is available on the TGA website.
Further information about BIA-SCC and other lymphomas is also available from the Australian Society of Plastic Surgeons.
Ongoing management
Should my breast implants be removed?
Currently, medical experts do not recommend breast implant removal in patients without symptoms or abnormality.
Other resources
Further information and resources relating to BIA-ALCL can be found on the TGA Breast implant hub.