Thursday, January 27, 2011

Do Breast Implants Cause Lymphoma? The Truth Behind the Association of Breast Implants & Lymphoma

Do Breast Implants Cause Lymphoma? The Truth Behind the Association of Breast Implants & Lymphoma

The FDA recently announced that  breast implants are associated with lymphoma.  "The FDA believes that women with breast implants may have a very small but increased risk of developing this disease in the scar capsule adjacent to the implant."   However, one should look at this very closely since it is not possible to confirm with absolute certainty that breast implants indeed cause lymphoma based on the available data.  According to the FDA, "currently it is not possible to identify a type of implant (silicone versus saline) or a reason for implant (reconstruction versus aesthetic augmentation) associated with a smaller or greater risk."

Fast Facts about Breast Implants and Lymphoma:    
  •  Approximately 1 in 500,000 women is diagnosed with Anaplastic Large Cell Lymphoma in the United States each year.
  • Anaplastic Large Cell Lymphoma in the breast is very rare:  ~ 3 in 100 million women per year in the US are diagnosed with lymphoma in the breast.
  • Incidence of ALCL of the breast in the Netherland study is 0.1 to 0.3 per 100,000 women with breast implants per year.
  • Chance of dying from a car accident in the US: 1 in 18,585
  • Chance of getting breast cancer:  1 in 9
  • The FDA identified 34 unique cases of ALCL in women with breast implants throughout the world from January 1997 to May 2010.  Currently, 60 cases were identified worldwide.
  • Of the 34 cases in the original study, 19 patients received implants for breast augmentation. 
  • The total number of patients with breast implants worldwide is estimated to be between 5-10 million.
  • There is a possible association between breast implants and lymphoma.
  • Currently, there is no data that would identify which breast implants (saline versus silicone) are associated with lymphoma.
  • Based on the available data, the incidence of Anaplastic Large Cell Lymphoma is extremely low, even in breast implant patients.
Treatment of Lymphoproliferative Disorder of the Breast Implant Capsule
  • The treatment would consist of capsulectomy (removal of the capsule) and implant removal.
  • Patients may or may not need chemotherapy or radiation therapy depending on the extent of the lymphoproliferative disorder found.
  • Currently, there is no consensus regarding the treatment regimen for ALCL of the breast since there has been very few cases worldwide.  The prognosis has been excellent based on the study conducted at the University  of Texas M.D. Anderson Cancer Center.
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Reference: 

US Food & Drug Administration:  Anaplastic Large Cell Lymphoma (ALCL) in Women with Breast Implants:  Preliminary FDA Findings and Analyses.  January 2011

Atlanta Breast Symposium. January 2011
Kim B, et al. Anaplastic Large Cell Lymphoma and Breast Implants: A systematic Review: Plastic & reconstructive Surgery. 2011 June; 127:2141-2153
Roden et al. Seroma-associated primary anaplastic large-cell lymphoma adjacent to breast implants: an indolent T-cell lymphoproliferative disorder. Mod Pathol. 2008 Apr;21(4):455-63.
Jong, et al. Anaplastic Large Cell Lymphoma in Women with Breast Implants. JAMA. 2008;300(17):2030-2035
Miranda RN, Lin L, Talwalkar SS, Manning JT, Medeiros LJ. Anaplastic large cell lymphoma involving the breast: a clinicopathologic study of 6 cases and review of the literature. Arch Pathol Lab Med . 2009 Sep;133(9):1383-90. 

Article updated on 06/15/2011

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