Several news sources recently reported that women with breast implants may be at increased risk of developing a rare form of non-Hodgkin lymphoma called anaplastic large cell lymphoma (ALCL). These reports are based on recent studies that suggest an association between ALCL and breast implants. In order to adequately understand the recent reports, it is important to have some background information.
ALCL is an uncommon form of T-cell lymphoma and it has at least three different subtypes: 1) Systemic ALK-positive ALCL; 2) Systemic ALK-negative ALCL; and 3) Primary cutaneous CD30-positive ALCL. This latter form typically caries an excellent prognosis and is usually managed with locally directed therapy; i.e., surgery or radiation but not chemotherapy.
Non-Hodgkin lymphoma occasionally involves breast tissue. The lymphoma subtypes that most commonly involve breast tissue are diffuse large B-cell lymphoma, Burkitt lymphoma, and mucosa-associated lymphoid tissue (MALT) marginal zone lymphoma. ALCL is extremely uncommon in the breast tissue of women without breast implants.
Over the past 15 years, multiple researchers have reported cases of women with breast implants and ALCL. A recent review of literature revealed that among women with breast implants and breast lymphoma, the majority of cases were ALCL, not the other more common lymphomas. As a whole, these studies suggest that there is a strong link between breast implants and ALCL of the breast.
It should be noted, however, that the risk of developing ALCL in women with breast implants appears to be extremely small. Millions of women have breast implants, but there have been fewer than 100 reports of implant-associated ALCL of the breast. Moreover, it appears that the subtype of ALCL that develops most commonly is similar to the cutaneous CD30+ ALCL and can be cured with surgery alone; i.e., no chemotherapy.
For the time being, the FDA is monitoring the situation carefully. The American Society of Plastic Surgeons is working to create a registry of cases in order to improve the quality of research.
Given the number of news reports, it seems there is a lot of interest in this topic. We will be following it closely.