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ALCL (ANAPLASTIC LARGE CELL LYMPHOMA)

Update on ALCL (Anaplastic Large Cell Lymphoma) associated with breast implants. Disclaimer: This information is imprecise at best may not be accurate at all. It was gleaned in conversation at the ASPS 2013 congress in Melbourne, Australia. If it was rock solid, we’d be publishing it in a peer reviewed medical journal…it’s not, which is why we’re publishing it on our website.
ALCL (Anaplastic Large Cell Lymphoma) is a rare type of non Hodgkin lymphoma, a malignancy of the immune cells. In the last few years there have been reports published in the medical literature of ALCL being associated with the scar tissue capsule around breast implants. Note I’ve said “associated with” not “caused by”, but time and further research may scientifically prove that it is, in fact, “caused by” breast implants. It seems it can happen with both silicone and saline implants, and both cosmetic and reconstructive cases. All patients make a scar tissue capsule around implants, it is a normal response of the tissues to a foreign material inside the body.

It’s a very rare problem, in Australia we believe there have been 12 cases of it, which makes the incidence of it approximately 1 in 20,000. Worldwide there have been approximately 150 cases of it reported to date, with apparently 2 patients dying of the disease. It presents with various symptoms, but late onset persistent seroma (fluid) around an implant may be a pointer to ALCL, as may the development of lumps around the implant. The bottom line is, if you’re worried get checked by your surgeon. If you had your surgery overseas…well, you made your choice! You’ll still need to be checked by someone of course but it may be more difficult to find a surgeon willing to see you in private. The public hospital system would be an appropriate option in that circumstance. Below are some links to information about ALCL.

American FDA statement

Australian TGA statement

P.S. It seems some patients considering breast surgery with implants may be ‘put off’ by their knowledge about ALCL. It’s worth keeping it in perspective. You possibly have a 1 in 20,000 chance of developing ALCL if you have implants**. With or without implants, you approximately have a 1 in 8 chance of developing breast cancer, a 1 in 14 chance of developing bowel cancer, a 1 in 75 chance of developing ovarian cancer and a 1 in 42 chance of developing Non-Hodgkins Lymphoma in your lifetime. Just about every activity or decision you make in life carries some risk. In plastic surgery, we are very particular about making our patients aware of the potential risks they face, so they can be weighed against the potential benefits in each individual’s case. We are here to help our patients to make sensible, informed, considered decisions…if you’ve got questions, please ask!

** This is a rough guesstimate for Australia based on 12 cases in maybe 250,000 implants. Worldwide, with approximately 150 cases reported and 15 million breast implants used, the risk is closer to 1:100,000.

This update was brought to you by Dr Mark Baldwin.
For more information please call 03 8560 2999 or email enquiries@horizonplasticsurgery.com