The number of women having immediate or delayed breast reconstruction following mastectomy is increasing in New Zealand and Australia. Implants are commonly used for breast reconstruction, and their safety has been debated extensively since the 1960s.
Anaplastic Large-Cell Lymphoma in the Breast
Anaplastic large-cell lymphoma of the breast is extremely rare, only 1 in 3 million women without breast implants will develop it by the age of 75.
The first report of increased risk of anaplastic large cell lymphoma of the breast was published in 2008. A recent study performed by Dr de Boer and several other researchers from the Netherlands (JAMA Oncol in 2018) has confirmed this.
Dr de Boer et al. have looked at all women in the Netherlands who have developed anaplastic large-cell lymphoma of the breast and compared these patients to those with other types of breast lymphomas.
Presence of implants was only associated with an increased risk of anaplastic large-cell lymphoma, not other types of lymphomas. This risk is 421 times higher for women with implants in comparison to those without implants. But the absolute risk is still low. By the age of 75, only one of 6920 women with implants will develop this type of lymphoma.
Dr de Boer and her colleagues have also looked at specific types of implants that may be associated with increased risk. They have found out that macrotextured implants are associated with a more significant risk.
The cause why implants may lead to an increased risk of anaplastic large-cell lymphoma is not known. It is postulated that it may be due to an immune system response or an inflammatory reaction to implants.
It is not known whether the increased duration of presence of implants is associated with increased risk.
Having breast implants does increase the risk of developing a breast anaplastic large cell lymphoma. This risk is still small, only 1 in 7000 women with implants will develop it.
If you are considering having implant-based reconstruction, please discuss with your plastic or breast surgeon type of implants used and their risk of developing this type of lymphoma, as well as any other complications.
I am Breast, Endocrine and General Surgeon.
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