Aggressive Breast Implant Lymphoma Variant Described In Case Report

A new case report warns about the risk of an aggressive strain of breast implant-associated lymphoma, which could lower the chances of survivability.

In next month’s issue of the medical journal HemaSphere, researchers from the University of Louisville published details about a 67 year old woman who suffered vision loss due to this more aggressive variant of cancer linked to certain breast implant designs used in recent years.

Last year, Allergan was forced to issue worldwide breast implant recalls for its entire line of “Biocell” macrotextured products, after the design was linked to reports of a rare lymphoma that may develop in the tissue surrounding the implant.

Hundreds of cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) have been identified nationwide, which may be caused by chronic inflammation from the textured design. However, there has been little guidance for women who still have the breast implants in their body, or those diagnosed with the rare cancer.

In this case study, researchers noted the first reports of the condition, then known as breast implant-associated peripheral T-cell lymphoma (BIA-PTCL) was reported in 1997. Since those first cases, two clinical variants emerged, one of which is a more aggressive infiltrative mass.

Unfortunately, in this specific case report, it was fatal, and was misdiagnosed due to a lack of familiarity with the variant, and with breast implant lymphoma as a whole.

The researchers described problems experienced by a 67-year-old Hispanic-American woman, who was found wandering the street and disoriented. She was taken to an emergency room and indicated she had gradually lost her vision, and could only discern between light and dark and finger movements.

The report indicates she had seen an optometrist and was prescribed prednisone, but it brought no relief. However, doctors realized she had received breast implants 42 years earlier, and an examination revealed a large breast mass and breast implant lymphoma.

The woman received palliative care and died four weeks later, because her cancer was too advanced, and healthcare professionals had not detected the aggressive form of breast implant lymphoma.

“Our current understanding is that there are 2 clinical variants of BIA-ALCL, presenting as either the more common periprosthetic seroma or an infiltrative mass,” the researchers noted. “These 2 variants have different prognoses, with the infiltrative variant having more aggressive biology and worse outcomes. However, no specific pathologic features differentiating these 2 groups have been elucidated. Indeed, it is unclear if these are distinct subtypes, or simple represent a spectrum of disease.”

The study comes as Allergan faces a growing number of breast implant lawsuits filed by women diagnosed with the rare lymphoma, as well as women who have required removal of the recalled implants due to concerns that they may develop the cancer in the future. The complaints all raise similar allegations that the manufacturer knew about problems associated with the textured design for years, yet failed to warn women, the medical community or federal regulators, continuing to promote the textured design as safe and effective.

There are currently at least 300 class action and product liability lawsuits filed throughout the federal court system, which have been consolidated for pretrial proceedings in New Jersey. However, as breast implant cancer lawyers continue to review and file claims in the coming weeks and months, the size and scope of the litigation is expected to continue to grow.