Several cases of a rare form of cancer related to breast implants have been reported to US health authorities.
Today, an estimated 10 million women worldwide have breast implants. And for almost all of them, everything is going well. However, in very rare cases, the wearing of these prostheses has triggered the appearance of anaplastic large cell lymphoma, a cancer of the immune system. In the United States, the Food and Drug Administration (FDA) has just sounded the alarm, reports the New York Times. On the occasion of an update at the end of March of its website, the US health agency has indicated the existence of a link between breast implants and a risk of large-cell anaplastic lymphoma. Several hundred women with breast implants worldwide have thus developed this rare and malignant disease of the immune system.
In the space of one year, according to the FDA, 55 new cases of ALCL caused by breast prostheses have been reported in the United States and other countries. A disease that has claimed the lives of nine women, adds the health agency, which however recalls that this increase could be explained by a better awareness and better screening for the disease.
This cancer is not a breast cancer but a type of non-Hodgkin’s lymphoma (cancer of the immune system).
By 2011, the FDA had already identified a possible association between breast implants and the development of this cancer. Over the years, scientists have better understood the disease but the exact number of cases “is still difficult to determine because of the small number of reports in the world and the lack of data on global sales of breast implants” according to US health authorities.
But how can a breast prosthesis trigger the appearance of cancer in its carrier? “It would be related to the texture of the prosthesis,” says Dr. Vladimir Mitz, a cosmetic surgeon.
Breast prostheses are like eggs: “They have an outer membrane that forms a kind of protective shell, and the inside, which is composed of silicone gel,” says the practitioner. Over the last twenty years, great progress has been made on the technical qualities of prostheses. Initially, the manufacturers did not use a pure silicone gel, and there were cases of leaks through the membrane of the implant, which was too thin,” says Dr. Mitz.
Today, things have gotten better, “the prostheses are much safer,” insists the cosmetic surgeon. But zero risk does not exist, and “rejection reactions can be seen in patients,” says Dr. Mitz.
Sometimes a shell of scar tissue forms around the implant, which changes its shape and causes discomfort and pain to the patient, so that removal of the prosthesis is needed. To counter this risk, the research focused on the texture of the outer membrane of the prosthesis. Thus, today, there are several types of outer membranes for breast implants: “There are prostheses that have a textured surface, a little rough, like the prostheses of the American brand Allergan, one of the world leaders in the market and whose model of textured implants is implicated in ALCL cases. They are popular because it would allow a more aesthetic appearance and better support of the implant. There are those that have a microtextured and velvety surface, that I use for my patients, and those that have a smooth surface,” details the surgeon.
However, the rough surface of textured implants “could have an irritating effect in some women, causing an inflammatory reaction that can lead, in rare cases, to the appearance of lymphoma,” says Dr. Mitz. Another theory put forward by the researchers states that the rough texture of this type of implant could trap bacteria, causing a chronic infection that could eventually cause cancer, as reported by the New York Times.
For the American Society for Aesthetic Plastic Surgery, anaplastic large cell lymphoma “currently seems to develop exclusively in women with textured implants.” But the FDA, cautious, expects to have additional information on the texture of implants in patients who have developed a ALCL .