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

The Health Science Authority (HSA) of Singapore recently released a healthcare advisory informing medical practitioners and members of the public on the risk of Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), which have been shown to develop around breast implants. – risk of breast implant

What exactly is Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL)?

BIA-ALCL is a rare type of non-Hodgkins lymphoma that develops around breast implants. Is it not a cancer of the breast tissue.
If diagnosed early, BIA-ALCL can be successfully treated with surgery. However, in cases where the cancer has spread to other parts of the body, further treatment such as radiation or chemotherapy and targeted immunotherapy have been used.

When does it happen?

It usually occurs as early as 1 year after the breast implant surgery, or as late as 37 years after the breast implant surgery.

Who is at risk of getting BIA-ALCL?

Breast implants usually have a surface that is either smooth or textured. Globally, the majority of people who have developed BIA-ALCL have received textured implants. There have also been a few reports of people with smooth implants who got BIA-ALCL but these reports have been unconfirmed still. – risk of breast implant

In the Singapore Context

There has been one report of a patient with BIA-ALCL locally in Singapore, however, the diagnosis was made early and the patient’s prognosis is reported to be good.
There are currently 8 registered brands of breast implants in Singapore. Textured implants are associated with the highest risk of BIA-ALC L. The only brand in Singapore that is registered in Singapore is the Allergan Natrelle implant, which Singapore has since disallowed its sale as of April 2019. – risk of breast implant

What to do next?

If you are intending to get breast implants, have a discussion with your surgeon regarding the suitability of the various types of implants and the pros and cons.
If you already have a breast implant, there is currently no need for the removal of your implant.
However, it is important for you to take note of signs such as pain, swelling or lumps, especially around the implant.
Conduct regular breast self-examination and make sure you attend your regular check-ups with your doctor as this can aid in early detection of the disease.
Breast cancer screening can still be effectively carried out in women with breast implants, but special considerations do need to be taken.

Screening with mammogram can still be done for these women.

It is important for patients to inform the medical technologist conducting the scan about the presence of breast implants, so as to allow appropriate positioning to optimize visualization from the mammogram.
It may be possible that the implants may obscure the view of breast lumps depending on the location. Hence positioning of the breast is important, and additional views and images are also taken to minimize the chances of missing detection of a lesion.
While rare, there is also a slight risk of implant rupture due to compression during the mammogram.
Other imaging modalities such as MRI breast or ultrasound can also be conducted for women with breast implants.

Take Care!

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