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Advice for patients with textured breast implants and tissue expanders

A rare form of cancer can occur in people with ‘textured’ breast implants. It is called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). 

BIA-ALCL is a slow-growing cancer also known as non-Hodgkin’s lymphoma. It is not a breast cancer. It is a cancer of the immune system.

BIA-ALCL usually takes an average of 8 years to develop after the implant but this can range from 1 to 20 plus years. When diagnosed and treated early it has a very good recovery rate. 

Related topic

Non-Hodgkins lymphoma - Irish Cancer Society

Causes

It is not known why BIA-ALCL occurs. But, this type of cancer is most commonly found in people with textured breast implants or tissue expanders. 

One brand of textured implant is Allergan BIOCELL. This has been most associated with this cancer. Allergan BIOCELL textured implants are not used in Ireland anymore. This type of implant has not been used in Ireland since December 2018. 

If you have an implant, you are unlikely to know if it is textured or not. Our hospitals are writing to people who have received textured breast implants or tissue expanders during surgery in Ireland.These letters will have advice on what you should do if you are concerned.

International medical experts advise that people without symptoms should not have their breast implants removed.

If you had your implant surgery in a private clinic and you’re concerned about BIA-ALCL, contact the clinic directly.

If you have had breast implant surgery outside Ireland, contact the clinic and ask them what type of implants you have. If you are concerned about any signs or symptoms talk to your GP and tell them you have textured implants.

Planned breast implant surgery

If you are scheduled to have breast implant surgery talk to your surgeon. Discuss the risks and benefits with them. Make sure you are comfortable with your decision. 

Symptoms

Common symptoms include:

  • swelling in the area of the implant 
  • substantial change in the size of the affected breast which comes rapidly on over days or weeks
  • discomfort - the affected breast might feel tense or firm

Less common symptoms include:                                                                    

  • pain
  • a hard lump beside or near the implant
  • lumps in the armpit on the same side 

These symptoms are usually only on one side. But, they can be on both sides. 

If you notice these symptoms, contact your surgeon. If you cannot make contact with your surgeon, contact your GP. If they think it may be BIA-ALCL, you will be referred to a breast clinic. 

Fluid can collect around your breast implant for other reasons that are not BIA-ALCL. For example, as part of the healing process after surgery.

If you have no symptoms you do not need to do anything. As always, it is important to be breast aware. This means checking your breasts regularly and knowing what is normal for you. This way, if there any unusual changes in your breast, you will notice. 

Related topic

How to check your breasts

If you are between the ages of 50 and 67, you should continue to go for breast screening as usual.

If you are currently having treatment for cancer

If you are in the 5-year follow-up care plan and have concerns about BIA-ALCL, talk to your doctor. If you are no longer having follow-up care, you can make an appointment to see your surgeon.

If you have symptoms such as pain, swelling or lumps in your breast please contact your doctor for a review. They may refer you to a specialist, if needed.

Treatment

BIA-ALCL has a good response to treatment. In 80% of cases, the disease is in a very slow developing phase when diagnosed. The cancer is confined to the liquid contained in the swelling (seroma). 

BIA-ALCL is treated by removing the implant. Usually, no other treatment is required. 

You do not need to have your implants removed unless BIA-ALCL is confirmed with a diagnosis.

For a small number of people, the disease can be more widespread. These people will need more aggressive treatment such as chemotherapy or radiation therapy. But, even in these cases, the outcomes are good.

Information updates

This is an evolving situation. The most up-to-date advice and information will be available on this web page and the HPRA website