Anaplastic Large Cell Lymphoma associated with breast implants

Anaplastic Large Cell Lymphoma associated with breast implants

13th August 2019

Mr Haresh Devalia is a Plastic and Oncoplastic Breast surgeon at Nuffield Health Tunbridge Wells Hospital and is among the first 10 breast surgeons certified in cosmetic breast surgery under the Royal college of Surgeons’ scheme. Here he answers some common questions concerned with breast implants and ALCL.

What is Anaplastic Large Cell Lymphoma (ALCL)

It is breast implant associated anaplastic large cell lymphoma.  It is commonly associated with heavy textured breast implants used for breast augmentation or breast reconstruction. 

What is the incidence of ALCL

It is approximately 1 in 24000.

Which implants are associated with ALCL

There are two types of breast implants; smooth surface silicone implants or textured implants.  Texture is required to prevent rotation or scar tissue.  There are no confirmed cases of ALCL with smooth surfaced implants, however heavy texturing is associated with ALCL.

What causes it

The cause appears to be multifactorial and there are many theories.  However, it is related to stimulation of our immune system cells, called T cell lymphocytes.  It could be related to infection or shedding of silicone particles from textured implants.  Some patients may also have genetic predisposition.

What are the symptoms

The symptoms generally appear five to six years after surgery.  Most patients present with swelling around the breast implant, which is called seroma or fluid collection.  Some patients can present with a mass, capsular contracture or a skin rash.

How is the diagnosis made

Patients with suspected ALCL require a specialist referral.  Examination involves a clinical examination, mammogram and ultrasound scan.  Fluid around the implant is drained with the help of ultrasound and sent for special immunohistochemistry analysis.  Some patients require a PET scan to stage the disease.

What is the treatment

Early treatment with complete removal of the capsule and implant is associated with an excellent prognosis.

Can I have implants inserted again at the time of removal of my  implants

The ideal treatment is complete removal of the capsule with the implants, however, one can recommend inserting smooth breast implants, as there have been no confirmed cases of ALCL with round, smooth surface implants.

What do I need to do if I have symptoms

You should directly report to your GP or contact Nuffield Health on 01892 888199 should you have any of the above symptoms. 

Mr Devalia uses a multidisciplinary team approach along with Radiologists and Pathologists, to ensure that an ALCL diagnosis is excluded confidently.  He has also treated patients with anaplastic large cell lymphoma and successfully removed the entire capsule and the implant.

Mr. Devalia and Mr. Dani, Consultant Plastic and Oncoplastic Breast Surgeon,  take pride in revising complex breast cosmetic procedures and enhancing aesthetic breast appearance. In recognition of their exemplary work, they have won the award of best Oncoplastic and Aesthetic Breast Surgeons, England.

Mr Haresh Devalia

MBBS. MS. DNB. MSc (Cardiff). FRCSEd. FRCS (Gen Surg)

Consultant Breast, Plastic & Oncoplastic Surgeon

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