Do Breast Implants Cause Cancer?

The short answer: possibly, but the long answer is much more involved and not nearly as simple.

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 the recent media of breast implants causing breast cancer are referring to BIA-ALCL, 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 entities with very different prognosis and treatments.

There are several factors which make the two cancers very different. The first 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 in over 50,000,000 women with breast implants and they all have one thing in common: they all had breast augmentations with textured breast implants. As far as we know there has never been a case of BIA-ALCL in a woman who had smooth breast implants. So, what is it about textured breast implants that makes BIA-ALCL only occur in those patients? We believe the texturing on the breast implant allows for bacteria to hideout within the nooks and crannies within the silicone shell. Bacteria is smart and it knows that as soon as it’s in the body, the immune system will be looking for it. So is does something very unique, the few bacteria cells make a covering over the cells 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 so the immune cells mutate. This mutation then prevents the cells from acting as they normally do and over a long period of time can eventually lead to the formation of a lymphoma. Most women presenting with BIA-ACLC have had breast implants for 10-15 years before any symptoms appeared because the cellular transformation takes a very long time.

The promising news about BIA-ALCL is that it is a very treatable disease. Current studies recommend removing the breast implants as well as the capsule around the implants. This procedure is curative in the vast majority of cases.

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. 1 micromort is a 1 in a 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 2 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 1 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 5 times more likely to die every time you drink a bottle of wine or every 4 days you’re in New York city than you are from BIA-ALCL related to textured breast implants!

So 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.

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 or breast augmentation surgery with San Francisco cosmetic surgeon Dr. Sieber, give us a call at 415-915-9000


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