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The US FDA sent out a warning on January 26 that women who have received breast implants may be at risk for a rare kind of immune system cancer called anaplastic large cell lymphoma.

US Regulatory Agency Warns Both Saline and Silicone Breast Implant Recipients at Risk

Over the last 14 years, about 60 women who have breast implants have developed this cancer in the scar tissue where the implant is inserted.

What is anaplastic large cell lymphoma? Imitating metastatic breast cancer and cancers of the breast muscle, anaplastic large cell lymphoma is sometimes called "lymphoma of the skin." It starts around an injured blood vessel just under the skin, and then spreads to lymph nodes throughout the body.

The cells that become cancerous are the white blood cells known as T-cells, specifically T-helper cells. These are the white blood cells that "put the brakes" on the activity of other white blood cells, and when they become cancerous, the immune system generates too many inflammatory hormones. About 50 per cent more common in men than in women, this form of cancer most often follows an insect bite, the malignant T-cells congregating around the bite and spreading on the surface of the skin. The incision used to insert a breast plant seems to have provided a platform for the cancer in about 60 women nationwide since 1997.

If I Have Breast Implants, Will I Get This Cancer?

The FDA itself states that women who do not currently have symptoms of this form of cancer have no reason for alarm. It's actually very easy to detect this kind of cancer when it occurs in the skin. There is a small, reddish brown area of indented skin surrounded by a lighter margin of redness. The area is jagged and irregular, looking like something many people would call a "nasty bug bite."

Detecting anaplastic large cell lymphoma at the site of a breast implant is a little harder to do, since the inflammation may be closer to the implant and farther from the skin, but there would be a tiny lump, about twice the size of an eraser on a pencil. Blood tests can quickly tell whether there is really a lymphoma.

Sometimes it's enough just to remove the lymphoma. Sometimes it's necessary to use chemotherapy or radiation. The overwhelming majority of people diagnosed with this kind of cancer live 5 years or more, even though the average age at diagnosis is 73.

And of the 900,000 cases of non-Hodgkin's lymphoma that have been diagnosed in the United States since 1997, only 60 have been tied to breast implants. The chances of developing a cancer because of a breast implant are very, very small. They just aren't zero. That's why the FDA issued a warning.

Women who do regular self-exams for lumps in the breast are likely to catch this problem, in the rare event it occurs, in plenty of time for uncomplicated treatment. No woman who have her breast implants removed because of this warning.

  • Diamantidis MD, Papadopoulos A, Kaiafa G, et al. Differential diagnosis and treatment of primary, cutaneous, anaplastic large cell lymphoma: not always an easy task. Int J Hematol. Sep 200, 90(2):226-9
  • Photo courtesy of bestinplastics on Flickr: