Valerie Lemaine, MD, MPH, FRCSC

As a plastic surgeon, patient safety is my top priority. I want anyone with breast implants to be aware of a recent recall linked to a rare lymphoma that may affect them.

In July of 2019, the breast implant maker Allergan issued a textured breast implant recall following safety concerns about the implant and its link to a rare type of lymphoma. These textured implants have been linked to breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which can develop around saline and silicone breast implants with textured surfaces.

There have been 13 deaths in the U.S. and 33 deaths worldwide linked to this lymphoma. Depending on the study or region, incident estimates range from one in 1,000 women to one in 30,000 women. This lymphoma develops anywhere between two years and 28 years after the implant surgery, with an average of eight years. 

The Food and Drug Administration is taking action. In October, it announced that surgeons should discuss the serious risks of these implants with women and that manufacturers should print bold warnings on the device packaging.

While there are many uncertainties about BIA-ALCL, we do know that the women who have developed this lymphoma exclusively had textured breast implants. It does not matter if the implants are saline or silicone; it’s all about the surface of the implant being textured. It is also important to note that it is not a cancer of the breast tissue itself.

Though this cancer is rare, it is important for women to recognize the signs. The main symptom of BIA-ALCL is a swelling of the affected breast. The swelling is caused by fluid that builds up around the implant. It is not a subtle amount of fluid; the breast will look visibly larger and it can be a drastic change. This swelling will occur relatively rapidly in a matter of days or weeks, so women should know that something is wrong. Less common symptoms include a lump in the affected breast or in the armpit, hardening of the breast, an overlying skin rash and associated pain.

To diagnose this lymphoma, the first step is usually to do an ultrasound of the breast. The treatment for this lymphoma would be to surgically remove the implant and the scar tissue around it. Typically, that is the only course of treatment needed for people who seek care in a timely manner. In cases where the disease is more advanced, additional treatment may include chemotherapy or radiation therapy.

Women who have died from this lymphoma did not seek care in a timely manner, so I urge women with textured breast implants to do regular self-breast exams and visit their plastic surgeon annually at the very least. Staying informed, in tune with your body and in touch with your doctor will give you the best chance for an early diagnosis and positive outcome.

Dr. Valerie Lemaine is a leading plastic surgeon in Minnesota. She practices with Plastic Surgery Consultants/Minnesota Oncology.

Valerie Lemaine, MD, MPH, FRCSC

A Plea to Women with Textured Breast Implants: Talk to Your Doctor Today

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