Breast Implant Associated ALCL Treatment in Dallas

Background:

  • Each year 1.5 million breast implants are placed worldwide
  • Over 10 million women worldwide with breast implants
  • BIA-ALCL is a rare cancer arising from fluid or a capsule around a breast implant. It is a T-cell lymphoma
  • The FDA is currently reviewing the data of textured implants and BIA-ALCL
  • Breast Implant Associated Anaplastic Large Cell Lymphoma is much more common in a textured implant
  • Europe has recently banned the sale of many textured implants because of this concern. The FDA has recently recalled all Allergan textured implants

How common is BIA-ALCL?

  • 1 in 500,000 women with breast implants
  • 1 in 30,000 women with textured breast implants
  • 573 total cases of BIA-ALCL described worldwide and 33 deaths (possibly under reported)

What is a textured implant?

  • Has an irregular surface to the silicone shell
  • Purpose was to decrease capsular contracture
  • Most anatomic or “tear drop” implants are textured implants
  • Allergan uses a Biocell or “salt loss” technique
  • Mentor uses a Siltex or “negative imprinting” technique
  • Sientra uses a hybrid technique

What causes BIA-ALCL?

Many theories:

  1. Chronic bacteria around an implant in women who might be genetically pre-disposed
  2. An immune response to chronic inflammation around an implant

How to diagnose BIA-ALCL?

  • A patient will present with fluid around an implant greater than 1 year after breast augmentation (the average is 8 – 10 years after)
  • First step would be to get an ultrasound aspiration of the fluid and send it for CD30 immunohistochemistry
  • If that is positive then the patient will be referred to an oncologist to have staging PET/CT scans (looking for capsular masses or positive lymph nodes)

Surgical treatment for BIA-ALCL?

  • A total capsulectomy is recommended with removal of the breast implant
  • Consider removal of the other breast implant and capsule as well

Follow up for BIA-ALCL?

  • Recommend seeing your oncologist for follow up scans every 6 months for 2 years
  • Depending on staging they may recommend chemotherapy although a total and complete capsulectomy is usually curative for most patients

Schedule

Schedule a private consultation with Dr. Surjit Rai to discuss your health concerns.


7777 Forest Lane, Suite C612,
Dallas, TX 75230

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