In recent years, important data has been collected internationally that has contributed greatly to our understanding of textured breast implants.
An uncommon condition, known as Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA- ALCL), has been described in a small number of patients who have received textured surface breast implants. If detected early, BIA-ALCL is very treatable. At the present time, Health Canada is intending to suspend the use of textured breast implants as a precautionary measure. Currently, Health Canada is not recommending removal of textured breast implants without a significant medical indication.
In most reported BIA-ALCL cases, the initial presenting symptom is significant swelling of the affected breast. You would notice this as a substantial size change on the affected side. Other symptoms may include redness or changes in firmness or lumps around one or both implants. Usually the swelling comes on rapidly, over several days or weeks, not over months or years. Typically, this occurs on one side only, but in exceptional cases can occur in both breasts.
Just over a year ago I saw a patient who had textured implants placed while living in Mexico. She developed a rapidly swollen breast over 1 week. Her affected breast was at least twice the size of her opposite breast. It was not red or painful. I aspirated the fluid in the breast and sent the fluid off for testing (CD30 and ALK-) and it came back as positive. At this point I booked her for the OR urgently and did an “enbloc” capsulectomy and removal of both breast implants. An “enbloc” capsulectomy removes the entire capsule as one piece. After capsulectomy and implant removal I referred her to Sunnybrook Hospital where there was an Oncologist interested in ALCL. After assessment she required no further treatment.
If you notice any of these changes or symptoms, please call our office and come in for a follow-up visit. There are some minimally invasive investigations such as ultrasound and aspiration of any fluid that can be done to determine whether you have BIA-ALCL and whether you need any treatment.
In addition, it has always been our practice to encourage patients with any breast implant to return for regular follow up at least every 2-3 years. This is important so that we may inform you about new information or changes regarding breast implant technology and safety.