Breast Implant ALCL

To my patients:

In light of recent media reports, I believe that is important that you get some clarity on the evolving news surrounding breast implants.

In 2011, a rare type of cancer called anaplastic large cell lymphoma (ALCL) was identified in association with breast implants. ALCL is a type of lymphoma that manifests as fluid and sometimes a mass in the scar tissue surrounding the breast implant. While the true incidence is difficult to determine, the FDA has 457 unique case reports as of September 2018. To put this in perspective and to avoid any false alarm, breast augmentation is performed over 300,000 times in the United States alone each year. This condition is extremely rare.

Over time, we as plastic surgeons have strengthened our understanding of this condition and the implications it has for our patients. We know that breast implant-associated ALCL more commonly develops following implantation of breast implants with textured surfaces rather than those with smooth surfaces. If you have breast implants, it is important that you schedule regular follow up exams with us and continue with routine screening mammography. Additionally, the FDA recommends that women with breast implants evaluate the implants with an MRI 2 years following surgery and every 3 years after that. This recommendation may be changing to ultrasound because it is more cost effective.

ALCL is typically identified when a fluid collection, swelling, or a mass develops around the breast implant more than a year after surgery. This emphasizes the importance of self-breast exams and continuous surveillance for breast masses and any abnormalities with your implants. If you notice anything abnormal with your breast implants, it is very important that you seek the expertise of a board certified plastic surgeon with experience in revision breast surgery. While this condition is rare it is important exclude it when revising your breast implants.

Some important points for patients with breast implants or those considering breast implants:
• If you have breast implants, there is no need to remove your breast implants or change your routine medical care.
• Breast implants do not cause breast cancer. ALCL is a rare type of lymphoma that arises in the scar tissue around the implant.
• Before getting breast implants, make sure to talk to your plastic surgeon about the benefits and risks of both textured-surface and smooth-surfaced implants—be sure to talk to your health care provider about the possibility of ALCL.
• Continue with routine mammography screening and inform your mammography facility that you have breast implants.
• After breast implant surgery, the FDA recommends that you evaluate the integrity of your implants with an MRI (or perhaps ultrasound) 2 years following surgery and then every 3 years after that for the lifetime of your implants.
• If you consider any surgery involving your breast implants, it is critical that you seek the expertise of a board certified plastic surgeon with experience in revision breast surgery.

Dr. Dauwe is always available to discuss this matter with you. Please do not hesitate to contact the practice if you have any questions. As always, we remain committed to you and want nothing more than to provide safe and efficacious plastic surgical care to you and all of our patients. We will continue to report on significant findings as new information and analyses become available.

Sincerely,

Phillip Dauwe, M.D.