Patients frequently show up at their breast augmentation consultation appointments and end up asking the question, “Do breast implants cause breast cancer”?
Unfortunately, the answer is quite complicated.
In short, it’s possible, but rare. The longer answer is not nearly as simple. So, let’s dive in.
Do Breast Implants Cause Cancer?
Although breast implants have been around since 1961, it wasn’t until 1997 that a woman was found to have developed a rare lymphoma called anaplastic large cell lymphoma (ALCL) related to her breast implants. Today, this lymphoma is called breast implant associated anaplastic large cell lymphoma (BIA-ALCL).
Reports in recent media of breast implants causing breast cancer are referring to BIA-ALCL, which is not related to primary breast cancer. It’s very important that patients understand the difference between BIA-ALCL and breast cancer as they are two totally different diseases with very different prognoses and treatment options.
How BIA-ALCL Differs From Breast Cancer
There are several factors which make these two types of cancers very different. The most important factor is that because BIA-ALCL is a lymphoma, it is a disease originating from the immune cells in the body and not from the breast tissue.
To date, there have been a little over 300 reported cases of BIA-ALCL worldwide. That’s in over 50,000,000 women with breast implants.
Furthermore, these women all have one thing in common: They all had breast augmentations with textured silicone breast implants. As far as we know, there has never been a case of BIA-ALCL in a woman who had smooth breast implants.
Do Silicone Breast Implants Cause Cancer?
It’s not silicone implants that are likely the causal factor with BIA-ALCL, but rather, the textured surface of some implants. Many patients get these features confused, so when they ask, do silicone breast implants cause breast cancer, it’s important to clarify the difference between silicone smooth implants and silicone textured implants.
Generally speaking, breast implant surgery with textured implants is performed when a patient wants teardrop or anatomical implants. The teardrop shape requires texturing so that the implants don’t rotate inside the implant pocket and cause an unnatural appearance.
So, what is it about textured breast implants that makes BIA-ALCL only occur in some patients? We believe the texturing on the breast implant allows for bacteria to hideout within the nooks and crannies of the silicone shell. Bacteria are smart, and they know that as soon as they enter the body, the immune system will be looking for them.
Therefore, they do something very unique: A few bacteria cells make a covering over themselves called a biofilm. This biofilm acts like a barrier between the bacteria and the immune system.
So, even though the body knows the bacteria is there, despite its best efforts, it can’t get to it to destroy it. What happens over time is that the normal immune cells get frustrated trying day and night to get to these bacteria, and then the immune cells start to mutate. This mutation then prevents the cells from acting as they normally do.
Over a long period of time, these textured breast implants raise the likelihood that the formation of a lymphoma may occur. Most women presenting with BIA-ACLC get through their recovery time for breast implants just fine and don’t have a problem for many years. It’s usually those who’ve had their breast implants for 10 to 15 years who end up showing symptoms after this time. This is because the cellular transformation process takes a very long time.
Symptoms of BIA-ALCL
Here are some of the symptoms that may be related to BIA-ALCL:
- Breast swelling
- Breast hardening
- Lumps in the armpit or breast
- Breast pain
- Red skin rash on or around the breast
Cosmetic Breast Augmentation and Cancer: Is BIA-ALCL Treatable With Breast Cancer Surgery?
The promising news about breast implant associated anaplastic large cell lymphoma is that it is very treatable. Current studies recommend removing the breast implant or implants as well as the scar tissue capsule around the implants (note: breast implants before and after the initial healing period post-augmentation look very different; the formation of scar tissue around implants occurs over time and is completely normal). Scar tissue and implant removal is curative of this rare cancer in the vast majority of cases.
Cancer Risk and Death Rate
So, what is your actual risk of dying from BIA-ALCL if you have textured breast implants for your entire life?
In order to understand this question we need to introduce a term called a micromort. One micromort is a one in 1,000,000 chance of dying from a certain activity.
The concept of micromorts was originally developed to help evaluate high risk activities such as mountaineering or skydiving, as well as other common everyday activities. For instance, drinking 0.5L of wine, living two days in NYC, riding a bicycle for 17 miles, riding in a car for 230 miles, or traveling by plane for 1000 miles all increase your risk of dying by one micromort.
In terms of BIA-ALCL, the micromort risk for a woman with bilateral breast implants over her lifetime is only 0.4 micromorts. That means you’re five times more likely to die every time you drink a bottle of wine or spend four days in New York City, than you are from BIA-ALCL related to textured implants!
Is the Risk Worth It?
The short answer is although there are reports of breast implants causing cancer, the incidence of BIA-ALCL is extremely low and if a woman is diagnosed early, the disease is very treatable.
Book a Consultation to Learn More
For more information on BIA-ALCL, please read my article in the Aesthetic Surgery Journal as featured in Allure and Refinery29 entitled, “What’s your Micromort? A Patient-Oriented Analysis of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).”
For more information on breast implants, breast implant shapes, or breast augmentation surgery with San Francisco cosmetic surgeon Dr. Sieber, give us a call at 415-915-9000 to schedule a consultation appointment.