BAPRAS responds to claim of increased Anaplastic Large Cell Lymphoma risk from textured shell breast implant

A recent popular media piece on this subject has suggested a potentially more widespread causal link with certain textured shell implants; however the article quoted un-referenced work which may not have been peer-reviewed.

This is sadly an example that information without perspective has the potential to lead to unnecessary anxiety among patients.

Graeme Perks, President of BAPRAS said:

“The most recent clinical studies state that it is not possible to confirm with any certainty whether breast implants have any relation to an increased likelihood of developing Anaplastic Large Cell Lymphoma (ALCL), and particularly whether any one type of implant can create a higher or lower risk than another of developing the disease."

This speculation, ironically on the day that the International Collaboration on Breast Registry Activities (ICOBRA) – to which BAPRAS and the UK Department of Health are memorandum of understanding (MoU) signatories – was meeting in Singapore, is further evidence of the need for a breast implant registry.

It should be noted that ALCL is extremely rare and treatable. This is evidenced in particular by two recent papers. A Danish nationwide study – 'Breast implants and anaplastic large-cell lymphoma: a Danish population-based cohort study' (reference 1 below) – concluded that in a nationwide cohort of 19,885 women who underwent breast implant surgery between 1973 and 2010, no cases of ALCL were identified.

A review of cases within another recent comprehensive article, 'Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients' (reference 2) concluded that: “most patients with breast implant-associated ALCL who had disease confined within the fibrous capsule achieved complete remission. Proper management for these patients may be limited to capsulectomy and implant removal. Patients who present with a mass have a more aggressive clinical course that may be fatal, justifying cytotoxic chemotherapy in addition to removal of implants.”

Until any further evidence is presented, BAPRAS maintains there is no need to remove these implants as a matter of course. We continue to advise that any women with breast implants who experience any sudden unexplained changes or swelling should speak to their GP or their surgeon.

Further references
1- Breast implants and anaplastic large-cell lymphoma: a danish population-based cohort study
Vase MØ, Friis S, Bautz A, Bendix K, Sørensen HT, d'Amore F.
Cancer Epidemiol Biomarkers Prev. 2013 Nov;22(11):2126-9. doi: 10.1158/1055-9965.EPI-13-0633. Epub 2013 Aug 16.
PMID: 23956025 [PubMed - in process] 
2-Breast implant-associated anaplastic large-cell lymphoma: long-term follow-up of 60 patients