Breast Implant Risks Among Transgender Community May Be Misdiagnosed, Misunderstood: Report

New research suggests that transgendered women, who are transitioning from male to female, may face particularly prominent risks from breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and breast implant illness symptoms, since the conditions may be misdiagnosed.

BIA-ALCL is a form of non-Hodgkins lymphoma linked to textured breast implant designs used in recent years, which has now resulted in a growing number of breast implant lawsuits filed on behalf of women who were never warned about the potential risk.

Breast implant illness, however, appears to be a different syndrome, and much harder to define. Many doctors now recognize certain symptoms among women as potentially being linked to their implants, including fatigue, cognitive problems, muscle and joint pain, hair loss, infections, gastrointestinal problems, rashes and thyroid issues.

A report published last week by MedTruth indicates that little attention has been paid to individuals who undergo breast augmentation to address gender dysphoria issues, who then suffer side effects from breast implants which may not be addressed due to misunderstanding and lack of education on transgender health issues among the medical community.

According to a 2015 survey, 11% of respondents in the transgender community had undergone breast augmentation surgery, and another 40% hoped to get breast implants one day. Not only can this help gender dysphoria issues, but being perceived as being cisgendered, or externally appearing to be female, can help them avoid harassment and even violence.

A third of respondents indicated they were verbally harassed, were refused treatment, or had to educate their health care provider on issues of transgender health. In addition, nearly a quarter said they avoided seeing a doctor due to fear of mistreatment. Among those who did seek transition-related surgery, 55% report they were denied medical insurance coverage.

In addition to risks of BIA-ALCL, many also report a failure to diagnose or acknowledge symptoms of breast implant illness by their health care providers.

A review published this summer in the European Journal of Breast Health found four cases of BIA-ALCL in the transgender population, and warned the population is often excluded from breast screening and follow-up, indicating cases could be missed, which can result in delayed treatment.

Breast Implant Health Concerns

In August, the FDA announced it has received 2,497 reports consistent with symptoms of Breast Implant Illness from November 2018 to October 2019. Before that, from January 2008 to October 2018, there had been only 1,080 such reports.

In another recent FDA update about the risk of breast implant malignant lymphoma, at least 733 cases of ALCL have been identified worldwide among women who received breast implants, with at least 620 of the cases linked specifically to Allergan implants.

Allergan issued a breast implant recall for its entire line of textured Biocell implants last year, after the FDA determined the design was linked to nearly all cases of BIA-ALCL. Since then, doctors have determined removing the implants is the best means of treating BIA-ALCL in most cases, but the manufacturer continues to refuse to pay for women to have the recalled breast implants removed.

Since the recall, there has been a sharp rise in the number of lawsuits filed against Allergan over the breast implants, each raising similar allegations that the textured design was unreasonably dangerous and defective.