Breast implant cancer warning

A rare form of the disease that has been linked to breast implants is on the rise - sparking fears it has been "very under-reported". The disease, known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), is hard to treat.

It is thought to have been triggered by textured implants which became popular 20 years ago, they have a slightly roughened surface, helping keep them in place and providing women with firmer boobs.

But the downside is, this may cause inflammation that can lead to cancer after several years.

Around 8,000 women had breast enlargement surgery in Britain last year. Currently, they are able to choose between smooth silicone implants and textured ones, which do not move around as much.

Professor Dino Ravnic, of the University of Pennsylvania State, said: "We are seeing that this cancer is likely very under reported, and as more information on this type of cancer comes to light, the number of cases is likely to increase in the coming years.

"We are still exploring the exact causes, but according to current knowledge, this cancer only really started to appear after textured implants came on the market in the 1990s."

Underestimated?

BIA-ALCL is estimated to affect 1 in 30,000 women with breast implants each year. But the researchers said the cancer could be more common, almost all of the cases were associated with textured implants.

Prof Ravnic and colleagues pooled data from 115 previous research articles in which 95 patients were evaluated to learn more about the development, risk factors, diagnosis and treatment of BIA-ALCL.

The analysis published in JAMA Surgery concluded BIA-ALCL may occur as a result of inflammation surrounding the breast implant. It said tissue that grows into the tiny holes in the textured implant may prolong that inflammation. Earlier studies have shown chronic inflammation can lead to lymphoma.

Researchers said not all patients and physicians may be aware of the risks associated with textured implants. They urged more work to identify the specific cause.

The first case of BIA-ALCL was only reported in 1997, around the time demand for them was growing. Researchers say because they could find no incidents of BIA-ALCL prior to the introduction of textured implants, this suggests a casual relationship, although more investigations are needed.

Prof Ravnic said: "All manufacturers of textured implants have had cases linked to this type of lymphoma, and we haven't seen cases linked to smooth implants.

"But in many of these cases the implant was removed without testing the surrounding fluid and tissue for lymphoma cells, so it is difficult to definitively correlate the two."

In the cases analysed, BIA-ALCL typically developed slowly, with good prognoses for patients who had both the implant and surrounding scar tissue removed. Of the 95 patients in the review, five died.

Textured implants suspected

The researchers recommend in the future, surgeons should communicate the risks of BIA-ALCL to patients. Physicians should also stress the importance of routine checkups after the implants are in place.

While some go under the knife as part of reconstruction after breast cancer, others do it to feel more confident. But the researchers say most are likely unaware of BIA-ALCL.

Deaths

There have been more than 350 confirmed cases globally, including at least nine deaths.

One patient, Kimra Rogers, from Idaho, US, learned that she had cancer last year after discovering a tumour under her arm.

She was shocked to discover that the cancer was possibly linked to the cosmetic breast implants she had received some 17 years ago.

Earlier this year, she said: "I was never informed that I could possibly get cancer. Basically they said they are 100 percent safe."

She added: "I want to get the word out to women, if you're thinking about getting implants, think twice.

"Truly if they would have said, 'Hey, there's a possibility here you could get cancer,' I would have taken that into consideration."