BIA-ALCL is a rare type of non-Hodgkin lymphoma linked to highly textured breast implants. It’s not a breast cancer, but a lymphoma, a cancer of the cells of the immune system linked to breast implants.
The causation is still not fully understood, but there are incredible researchers world-wide trying to get to the bottom of it. Dr Suzanne Turner is heading up the research of BIA-ALCL in the UK at Cambridge University and during my filming with Dispatches, I was honoured to meet her in her research lab.
As of June 2019, the MHRA (UK regulator) states that the chances of developing BIA-ALCL is 1:24,000 – although speaking with Mr Wilkinson, the head of medical devices at the MHRA, he has stated that this figure may well be inaccurate and underdiagnosed. This is because there are no real statistics to show how many women in the UK actually have highly textured implants, including the banned brand Allergan.
Signs and Symptoms.
Onset of symptoms normally occurs at least one year after implantation.
The most common presenting symptom is a swollen breast. This is caused through a seroma (fluid build up) between the implant surface and the fibrous capsule. Sometimes this can occur in both breasts, but that is very rare (1). Newly occurring asymmetry of the breasts.
- Pain in the breast(2)
- A hard lump(2)
- Inflamed/ large lymph nodes(2) in auxillia and armpit(4)
- Thickening of the scar capsule(4)
- Rash – on the breast, back (like shingles), can sometimes be similar to exzema(4)
- Itching which feels like a deep seated itch that you can’t get to. There is no relief from scratching(4)
- The symtpoms of inflammatory cancer can be the same symptoms as BIA-ALCL(4)
Image taken from FDA website (3)
Investigation & Testing
A physical examination by a surgeon or clinician will occur.
An ultrasound guided aspiration (collection of the fluid) will occur and then be sent off for specific testing, CD30 and Anaplastic Lymphoma Kinase (ALK) markers.
BIA- ALCL can only be confirmed if the CD30 is positive and the ALK is negative.
If there is a lump, this will also be biopsied.
If BIA- ALCL is confirmed, a PET-CT scan may also be performed to rule out any spread of the disease.
If lymph nodes in the armpit are abnormal, then they will also be removed and sent for testing. This would normally be performed at the time of the explant surgery(1)
Removal of the implant and the scar tissue known as a capsulectomy.(1)
If the capsules are not removed the risk hasn’t been removed. ALCL will continue to grow without implants in dwell. See below link for more information on en bloc. (4)
BIA ALCL surgery and En Bloc resection. Images of asymetric breast, surgery (graphic). Click here for paper… Enblock-BIA-ALCL
Possible follow up treatment depends on the stage of the disease.
Stage I = explantation of implant and capsule
Stage II+ = requires more aggressive treatment, such as chemotherapy
If caught early, removal of implant and capsule is normally enough to cure the disease(1)
Asking for help from women that have just been given the news they were dreading feels wrong. But if it wasn’t for other incredible women that have already been in this situation who have given their time, the research already completed couldn’t have happened and we are just so grateful.
Everything you need to know about this study is on this cancer research link below …
This study is looking at tissue samples, breast implants and blood samples from women with breast implant associated anaplastic large cell lymphoma. It is run by the lovely Dr Suzanne Turner.
Dr Suzanne Turners research papers:
Leigh Day is investigating potential legal claims for those who have textured Allergan implants and are concerned about BIA-ALCL. https://www.leighday.co.uk/Allergan-claim
Support Groups & Websites
Group : BIA- ALCL https://www.facebook.com/groups/ALCLinwomenwithbreastimplants/
- Turton.P, Johnson.L, (n.d) BIA-ALCL [online] https://associationofbreastsurgery.org.uk/clinical/bia-alcl/ [accessed 17 June 2019}
- Kricheldorff, J. Fallenberg, E.M. et all. (2018) Breast Implant- Associated Lymphoma [Online] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6218708/ [accessed 17 June 2019]
- Image – https://www.fda.gov/medical-devices/breast-implants/questions-and-answers-about-breast-implant-associated-anaplastic-large-cell-lymphoma-bia-alcl
- Information supplied by Terri McGregor BIA-ALCL group
This post is dediated to the amazing awesome and wonderful Julie Harris. The bravest lady I know, who is currently kicking BIA-ALCL to the curb. If this information had been available to Julie when she was showing signs and symtoms of this lymphoma cancer, then she wouldn’t be currently going through stem cell treatment to save her life. Please help raise awareness and share this blog post. Thank you. x