BIA-ALCL and Breast Implants

BIA-ALCL

Breast implant-associated anaplastic large cell lymphoma is a cancer of the immune system, not of the breast duct.

The approach

What it is, and how it is treated

BIA-ALCL is an uncommon lymphoma that can develop in the fluid or scar capsule around a breast implant. It is not breast cancer. The FDA has found the risk is higher with textured implants than with smooth implants. Cases have been reported years after the implant was placed.

The symptom that should not be ignored is a new swelling of one breast, a lump, pain, or asymmetry that shows up late. Evaluation usually includes imaging and sampling of the fluid around the implant. Pathology looks for cells that mark as CD30-positive and ALK-negative. That read is why Dr. Takasumi is in the same practice as the surgeons.

When the diagnosis is confirmed and the disease is limited to the capsule, the usual treatment is complete surgery: removal of the implant and the entire capsule. Some women need additional treatment. The FDA has not said that every textured implant must come out in the absence of symptoms. A confirmed diagnosis changes that plan. Surgery, when it is required, is coordinated by Dr. Funk and Dr. Sayah.

This is general information about how these questions are usually approached. It is not a diagnosis, and it does not replace a visit. Screening and treatment are planned for one person at a time.

How a suspected case is evaluated

Late swelling of one breast around an implant is the finding that has to be taken seriously. It can be a seroma from other causes. It can be contracture. It can be BIA-ALCL. Imaging looks for fluid. That fluid is sampled and sent for pathology, including markers that identify this lymphoma, rather than assumed to be ordinary swelling and drained in an office with no specimen.

Dr. Takasumi reads breast pathology, which is the point of having her in the practice when the diagnosis turns on a cell marker. A confirmed lymphoma limited to the capsule is treated by removing the implant and the whole capsule in a planned operation, not by swapping the device. More advanced disease needs additional treatment, coordinated with the appropriate oncology team. Dr. Funk and Dr. Sayah set the surgical plan together.

Textured implants carry the higher risk the FDA has described. Smooth implants have not been linked in the same way. Either way, new swelling is an examination, not a reason to search for reassurance online and wait.

Common questions

Frequently asked questions

Is BIA-ALCL breast cancer?

No. It is a lymphoma. It is treated differently from ductal or lobular breast cancer, which is why the pathology has to be specific.

Does a smooth implant carry the same risk?

The FDA's review finds a higher risk with textured surface implants. Smooth implants have not been tied to the same risk. Any new swelling still deserves an exam.

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