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What Causes BIA-ALCL?

| August 10, 2022 August 2, 2023 | |


Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare form of cancer. Even if it is found in the breasts, BIA-ALCL is not actually breast cancer. Rather, it is a cancer of the immune system that can develop in the scar tissue capsule surrounding a textured breast implant.

The capsule forms around an implant as part of the body’s natural response to a foreign object. However, complications can arise since BIA-ALCL can develop in the excess fluid between an implant and its capsule.

According to a Food & Drug Administration August 2020 Report, there has been a total of 733 cases of BIA-ALCL worldwide – 384 cases of which are found in the United States. So far, there have been 36 reported deaths from BIA-ALCL.

Drs. Kocak & Tiwari Explain BIA-ALCL

In this video, Dr. Ergun Kocak, and Dr. Pankaj Tiwari explain what Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is.
Breast Implant Associated Autoimmune Disease Study Review

What Are The Risk Factors And Common Symptoms?

While BIA-ALCL is a rare disease, patients with textured surface implants are more prone to it. Researchers have yet to find the reason behind this. However, they speculate that the rough texture of these implants might be too abrasive.

The textured surface implant is also seen as a breeding ground for biofilm. A biofilm is a collection of microbes that produces a bacterial load. If a patient has had textured surface implants for a long time, their body’s chronic inflammatory response can lead to lymphoma.

The most common symptoms of BIA-ALCL are swelling, asymmetry, or pain in the area of a textured breast implant. Some patients may develop a lump in the breast or in the lymph node in the armpit. Others have less common symptoms like skin rash, fever, weight loss, and hardening of the breasts.

These symptoms can show within 7-10 years following their breast implant procedure.

Dr. Kocak & Dr. Tiwari Explain BIA-ALCL Symptoms

In this video, you will find out what they usually look for in diagnosing Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).
Bacterial Biofilm Formation on the Breast Implant Capsules

How to Diagnose BIA-ALCL?

Please schedule a checkup with a physician once you detect the symptoms. The doctor will review your medical history and do a thorough physical examination. To diagnose BIA-ALCL, they will also do a series of tests beginning with ultrasound or an MRI. These medical imaging tests are used to look for lumps or fluid accumulation around the implant or in the lymph nodes.

Should there be any excess fluid, your doctor will draw a sample via a needle biopsy. This will be sent to a laboratory for testing. The fluid will be examined to see if there are cancer cells and biomarkers. The results of this test will determine if the patient has BIA-ALCL.

What Are The Next Steps?

If you are diagnosed with BIA-ALCL, you will have to see an oncologist for a specialized evaluation. They will then refer you for a PET scan. This helps identify if the disease has spread throughout the body. The PET scan results can also determine the staging of cancer, which is important for treatment planning.

The primary treatment for BIA-ALCL is breast implant removal or explant surgery. Various techniques can be used in explant surgery, but the most advisable one is Total En Bloc Capsulectomy. This technique removes both the implant and the capsule.

Early detection is crucial because cancer can spread into the scar tissue capsule. If Total En Bloc Capsulectomy is performed early, it will already eliminate BIA-ALCL. But if the lymphoma has spread, you may need other treatments such as chemotherapy, radiation therapy, and/or stem cell transplant surgery.

How To Reduce The Risk?

Although BIA-ALCL is not common, it is wise to be proactive by detecting it early on. Early diagnosis can improve the outcome of your treatment. Annual checkups and monthly breast self-exams can help you recognize lumps or other issues before they get worse. When performing a breast-self exam, pay attention to any pain, swelling, lumps, asymmetry, or changes in breast appearance.

There are smooth surface implants if BIA-ALCL is causing you alarm. You may opt for them if you are considering a cosmetic or reconstructive breast procedure.

Communicate any concerns you may have with your surgeon. They should be able to help you arrive at an informed decision. One way they can help you is by giving you alternative procedures such as Fat Transfer Breast Augmentation and DIEP Flap Reconstruction.

Let Us Be Part of Your Team

From diagnosis to treatment, a cooperative effort from various specialists is crucial in addressing BIA-ALCL. This includes early detection, explant surgery, and cancer treatments that can ensure a favorable outcome.

The role of plastic surgery in treating BIA-ALCL is vital, but your chosen breast surgeon has to have the necessary skills to perform the procedure well.

Here at Midwest Breast & Aesthetic Surgery, we have performed countless breast implant removal procedures. We have a team of board-certified surgeons who can do Total En Bloc Capsulectomy, so that the capsule and the implant can be removed in one piece.

Schedule a consultation with us to know more about explant surgery.

About the Author

Dr. Ergun Kocak, MD, is a board-certified plastic surgeon who specializes in plastic and reconstructive surgery of the breast using DIEP, SIEA GAP, TUG, PAP, and direct-to-implant, in Columbus and Cincinnati, OH.
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*Our blog entries are written in order to further educate our patients and raise awareness towards topics related to plastic surgery. Any solutions offered on this blog are intended to help possible patients develop educated decisions before undergoing a consultation with our doctors.

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