Breast Implants After Mastectomy May Increase Risk of ALCL for Some Women: Study

Researchers recommend smooth-textured implants for women with a genetic disposition toward breast cancer.

For about a decade, researchers and federal health officials have expressed concern about a link between the use of breast implants and a rare type of cancer known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which has led to at least one brand of textured implants, Allergan’s Biocell, being removed from the market.

Now, a new study suggests the implants themselves may not be the only factor causing the condition. Women who developed breast cancer and had a mastectomy may face a higher risk of BIA-ALCL compared to those who got implants for cosmetic or non-cancer-related reasons.

According to findings published in Blood Advances on June 12, women with BRCA1 and 2 mutations, genes believed to increase the risk of breast cancer and ovarian cancer, were 16 times more likely to develop BIA-ALCL.

Breast Implants and BIA-ALCL

In June 2017, a study published in the medical journal Plastic and Reconstructive Surgery suggested that certain textured breast implants may be increasing the risk of ALCL, with results suggesting that women receiving the design may be anywhere from 10 to 14 times more likely to develop the cancer, when compared to those who received traditional, smooth breast implants.

Another study, published later that same year, warned that many breast implant cancer cases worldwide have likely not been reported, noting that doctors and patients may not be aware of BIA-ALCL.

In 2020 Allergan’s Biocell textured breast implants were linked to nearly all reported cases of BIA-ALCL and were removed from the market. Since then, the manufacturer has faced hundreds of Allergan Biocell breast implant lawsuits by women who developed the rare form of cancer. Allergan also faces class action claims representing all women who received the recalled implants, which may result in the need for removal surgery or life-long medical monitoring due to the increased risk of cancer.

In the new study, researchers from Memorial Sloan Kettering Cancer Center in New York looked at the impact of having the BRCA1 and BRCA2 genetic mutations, which are known to increase the risks of breast cancer and ovarian cancer, on the development of BIA-ALCL. They looked at a cohort of more than 3,000 Dutch women who received breast implants after being diagnosed with breast cancer.

The researchers, led by Paola Ghione, followed the women for a median of 11.5 years. After analyzing the data, researchers discovered that women with the BRCA mutations were 16 times more likely to develop BIA-ALCL than their peers. The study was restricted to the effects of textured breast implants, as smooth breast implants have never been linked to the disease

“In this study, we define the role of BRCA1/2 mutations as a risk factor in developing BIA-ALCL in patients with BC (breast cancer). These results will help women undergoing breast reconstruction or with textured implants in place.”

-Paola Ghione, BRCA1/2 impact on the development of implant-associated lymphoma in women with breast cancer and textured implant

According to the researchers, women having reconstructive breast surgery due to breast cancer should discuss the types of breast implants with their health care providers and determine how best to minimize the risk, which would likely include steering women with BRCA1 and 2 mutations toward smooth-textured breast implants.