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Miss Fiona Langlands Consultant Surgeon

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Yorkshire Breast Clinic.com

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Breast Implant Associated-Anaplastic Large Cell Lymphoma  (BIA-ALCL)

What is ALCL?

Anaplastic Large cell Lymphoma (ALCL) is a rare type of non-Hodgkin’s lymphoma of which there are several sub-types. This is a cancer of the white blood cells (Lymphoma)

In 2016,the World Health Organisation (WHO) defined a specific type of ALCL called Breast Implant Associated Anaplastic Large Cell Lymphoma or BIA-ALCL*. This has specific diagnostic criteria which includes expression of the marker CD30+ and negativity for ALK.

​As of September 2018, ther have been 57 reports in the UK of ALCL in patients with breast implants, 45 of which meet the WHO diagnostic criteria for BIA-ALCL.

In the UK, the estimated risk of BIA-ALCL, based on the reported confirmed cases is 1 per 24,000 implants sold. This estimate is based on data for all types of breast implants known to be sold in the UK and reported cases of BIA-ALCL confirmed to meet the WHO criteria until July 2018. This is an estimate as some cases may not have been reported to the manufacturer or to MHRA during this period, additionally all devices known to be sold in the UK may not have been implanted.

In cases of ALCL in women with breast implants reported to MHRA there have been 3 deaths. Only 1 of these is confirmed to meet the diagnostic criteria for BIA-ALCL. The other two deaths did not meet the diagnostic criteria.

Patients

The most common symptom for patients, who have developed BIA-ALCL around their breast implants, is to present with a ‘late’ seroma (a collection of fluid) forming around the breast implant. The fluid collection often results in a relatively rapid but painless increase in size of the affected breast. In some cases, it can affect both sides.

Most cases have happened years after surgery. Very rarely BIA-ALCL has been found when a lump develops next to the implant, or within the tough fibrous tissue building up around the implant (known as capsular contracture).

ALCL is rare, but it is important healthcare professionals and patients who have implants know about it. If you develop a seroma, a breast lump or swelling around your implant more than a year after having the breast implant (regardless of how many years later), you should seek advice from your surgeon or clinic.

If the surgeon or clinic which performed the original implant operation is no longer available, then you should see your GP for referral to another surgeon.

As with any implant it is important anyone undergoing breast implant surgery discusses the risks and benefits with their surgeon.

IF YOU AR CONCERNED ABOUT YOUR BREASTS OR IMPLANTS PLEASE SEE YOU GP AND ASKED TO BE REFERRED TO AN ONCOPLASTIC BREAST SURGEON WHO CAN ARRANGE URGENT ASSESSMENT OF YOUR BREAST TISSUE AND IMPLANTS.

THIS IS AVAILABLE ON THE NHS OR PRIVATELY IF YOU PREFER.​​​