Dr. Shafer agrees and says that there seems to only be an association of cancer with textured implants, which Dr. Sbitany says are breast implants with an external surface made from silicone that has a rough, sandpaper-like appearance to it. (“Most implants used in the U.S. are smooth implants,” says Dr. Shafer.)
Dr. Sbitany explains that textured implants are offered with the intention that they would have lower rates of scar tissue formation around the implants because it attaches to the tissue around them. But, he says, the interaction of this textured surface with the human body produces inflammation that may lead to BIA-ALCL in some patients.
Dr. Anderson adds that chronic inflammation has been proposed as a potential factor because it plays a role in the development of other types of lymphoma (such as MALT lymphoma of the stomach). Other areas that he says are being studied include the bacterial biofilms that may coat a breast implant and evaluating patient genetics to see if certain genes make patients more susceptible to BIA-ALCL or SCC. But even with all these preliminary theories being studied, he emphasizes the need for further research is needed to validate them.
Increased fluid collection is the main indicator of cancer related to breast implants.
Whether you’ve had breast augmentation or not, the symptoms that indicate you may have breast cancer are pretty much the same. Dr. Anderson says signs may include a lump felt in the breast, skin dimpling or changes to the skin, change in contour or size of the breast, and nipple discharge (especially if only on one side and bloody.)
For those who’ve gotten breast implants and recovered fully, Dr. Shafer adds that any new pain, swelling, fever, weight loss, and shortness of breath should always be evaluated by your doctor just to be safe. Dr. Anderson adds that patients should follow standard guidelines for breast cancer screenings, which include self-examinations and routine screenings. The FDA recommends starting screenings five years after implantation, and Dr. Anderson recommends MRI surveillance of silicone breast implants every two to three years.
Both he and Dr. Sbitany say an additional sign associated with BIA-ALCL is a fluid collection within the breast. This can look like sudden or spontaneous swelling of the breast and it can occur years after the implant is placed. They recommend immediately seeking a consultation with their plastic surgeon if you feel your implant may be collecting fluid.
Should you receive a cancer diagnosis, treatment is available.
In the rare instance that you are diagnosed with either BIA-ALCL or SCC, there are treatment options. Dr. Anderson says that BIA-ALCL is treated with surgery; once the diagnosis is made, the implant along with the implant capsule and any residual masses should be surgically removed. He adds that the majority of these cases are localized and are not shown to have spread to other parts of the body, making surgery the only treatment necessary. Should it spread, then he says treatments may include radiation and chemotherapy. For implants associated with SCC, he says treatment involves a combination of surgery, chemotherapy, and radiation as these types of cancers tend to be more aggressive. He says given the limited data on treatment, treatment plans should be made on an individualized basis after consulting with both a surgical and oncology team.
