Tuesday, July 31, 2018

Cancer Alert: Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Note: This article is an overview reflecting a recent health alert from various medical centers and clinicians about a possible cancer risk resulting from a specific type of breast implant.  If you may recognize yourself to be a candidate or have received a similar notice from your reconstructive surgeon, please contact your physician to get more details.

Since 2011, the FDA identified a confirmed link to a specific type of breast implant and breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL - a form of cancer of the immune system called non-Hodgkin’s lymphoma.  The World Health Organization (WHO) describes BIA-ALCL as a T-cell lymphoma that may arise within 7-8 years after the insertion of breast implants with textured surfaces.  Half of the reported cases were diagnosed with persistent SEROMA, a buildup of fluid around the implant region (see image) and presenting symptoms of swelling, pain, and redness and breast asymmetry of the affected breast.

By 2017, 359 cases of ALCL has been reported thus far and 9 deaths (2.5%) have been identified since the inception of this study where the majority of cases reported had textured implants versus smooth implants.  The very texture of the implant's coating has been said to cause inflammation and scarring that can led to lymphoma, while others attribute the texture to trap bacteria which leads to cancer.

According to the FDA, certain manufacturers have been reviewed and connected with implant-specific risks since 1999 associating their textured implants with ALCL.  Worldwide, approximately 1.4 million breast augmentations were performed in 2015. In the United States, 290,467 breast augmentations were performed in 2016; this represented a 37% increase from 2000.  BIA-ALCL most commonly occurs in patients of a median age of 52 years. The median time interval between breast implant and diagnosis is 9 years and ranges from 1 to 32 years.

Jennifer Cook, a diagnosed victim-turned advocate of BIA-ALCL awareness is promoting a global mission and educational program to support all women who are potential sufferers of this problem. "...there is extreme urgency because this disease can go from being curable with surgery to a disease that may take your life quickly-- because it's advanced...(in) a matter of a few months." In a private interview, she detailed her personal research and her actual experience of self-checking and finding anomalies and unusual feelings that breast surgeons addressed only with minimal concern. Her pro-activeness and perseverance led her to a powerful direction of self-preservation. "it was the biopsy of that lump that led to my diagnosis. I actually had a mass that was diagnosed before the explant ... like most cancers, you know the sooner you get to it, the much better chances you have.  The situation is obviously a huge concern because currently experts are advising women who test negative, that their seromas are benign and that they do not necessarily need to have their implants removed. We feel that this is misleading given the fact that at least five women we know of have recently had negative fluid but positive capsules."

Because BIA-ALCL has generally only been identified in patients with late onset of symptoms, implant removal in patients without signs or symptoms is not recommended.  Clinicians like Dr. Robert Bard (Bard Cancer Diagnostics, NYC) recommends a regular monitoring schedule for any adjustments or shifts in the current stasis of the implant and its surrounding area. "Fluid build up may be easily imaged by 3D sonography although it can be detected by MRI scans as well (9). Under ultrasound guidance, fluid may be aspirated and analysed in real time without rupturing the implant or puncturing nearby arteries."


It has been noted that among operable patients, total capsulectomy with removal of suspicious lymph nodes is the first line of treatment and complete surgical excision (capsulectomy and implant removal) resulted in better overall survival and event-free survival compared to patients who underwent a limited surgery or treatment with systemic chemotherapy or radiation therapy.






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REFERENCES:
1) https://www.prnewswire.com/news-releases/asj-study-puts-the-risk-of-death-from-breast-implant-associated-anaplastic-large-cell-lymphoma-into-plain-perspective-for-patients-300508556.html

2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828403/

3) https://www.fda.gov/medicaldevices/productsandmedicalprocedures/implantsandprosthetics/breastimplants/ucm241086.htm

4) https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239995.htm


5) https://www.plasticsurgery.org/for-medical-professionals/health-policy/bia-alcl-physician-resources/by-the-numbers


6) https://www.fda.gov/medicaldevices/productsandmedicalprocedures/implantsandprosthetics/breastimplants/ucm258564.htm

7) https://www.ncbi.nlm.nih.gov/pubmed/28481803


8) https://www.smh.com.au/healthcare/cancer-risk-spikes-with-one-type-of-breast-implant--and-bacteria-are-to-blame-20170512-gw3bbe.html


9) Bard R, 8th International Workshop on PET in lymphoma, Menton, France 2018


10) ALCL In Women With Breast Implants BIA-ALCL:
https://www.facebook.com/groups/ALCLinwomenwithbreastimplants/

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The information provided in this article is a compiled report from public websites whose links are listed in the REFERENCE section and the statements and quotes included are from actual interviews by those whose names are stated who provided express consent to the publishing of this material.  This article is not meant to be used to diagnose, treat or advise others about what actions they should take with regard to any medical condition.  No one should undertake or discontinue any treatment as a result of what they read on our blogs. The publisher(s), editors, sponsors or other  "supporting members" of AwarenessforaCure.org are providing a strictly educational service and are not responsible for the diagnosis or treatment of any specific health needs. and are not liable for any damages or negative consequences from any treatment, action, application or preparation to any person(s) reading the information in this article or its thread. Readers with medical needs should obtain appropriate professional medical supervision. References are provided for any informational purposes only and do not constitute endorsement of any websites or other sources.

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