Breast implant associated cancer: consumer information

Those at risk

In Australia, all reported cases of breast implant-associated cancer involve textured implants. According to the current evidence, breast implant-associated cancer isn't linked to either the contents (saline/silicone) or shape (round/teardrop).

Breast implant associated cancer is rare. A recent review of BIA-ALCL cases reported to the TGA, up until the end of 2021, indicates the following risk rate:

• Polyurethane-coated implants have an estimated risk of 1 in 1,800. ARTG no longer lists this kind of breast implant, but some people may still have them.
• Macro-textured implants have an estimated risk of 1 in 2,400. The ARTG doesn't include this type of breast implant, but some people still have them.
• Micro-textured implants have an estimated risk of 1 in 18,000.
• In Australia, there are no confirmed cases of BIA-ALCL in people with only smooth implants.

The risk of developing BIA-ALCL increases with greater texturing of the implant. Implants which have a smooth surfaced have not been associated with BIA-ALCL. In 95% of cases, breast implant-associated cancer happens between three and 14 years after the implant is inserted.

Diagnosis

A doctor will send you for an ultrasound if you develop swelling of an implanted breast. If fluid is present, it will be removed and sent to the laboratory for analysis. Most fluid collections are not due to BIA-ALCL, but the laboratory test will be able to tell for sure.

The specialist may also order an MRI or CT scan to see if the cancer has spread locally or distantly. A PET scan may be also used to assess spread.

A mammogram will check for breast cancer but is not useful for detecting BIA-ALCL.

Treatment and prognosis

Care is usually provided by a multidisciplinary team. Advice is sought from a:

• blood disease specialist with experience in lymphoma,
• cancer specialist, and
• surgeon with breast implant experience.

Around 80% of the time, cancer cells are found in the fluid around the implant, when it's still early. It's usually cured by removing the implant and capsule.

In the last decade, four Australian women have died from breast implant-associated lymphoma.

Even if ALCL only affects one breast, both implants are usually removed. A small but real risk exists that breast implant-associated ALCL can spread. If the cancer has spread, you may need chemotherapy, radiotherapy or surgery. It might be necessary to get more CT scans after follow-up.

Symptoms

It is important to know the symptoms of breast implant associated cancer. The most common symptom is swelling of a breast caused by fluid build-up around the implant. In some cases, it may appear as a lump in the breast or armpit.

As this is a rare disease, changes in your breast are unlikely to be breast implant associated cancer. For example, swelling immediately after your breast implant surgery is normal.

If you're worried about breast implant cancer, talk to your surgeon. If your original surgeon or clinic is no longer available, you should see your GP for a referral.

Checking for symptoms

Get to know the normal look and feel of your breasts. Self-examine your breasts regularly. You can do this in the bath or shower and include your armpits and up to your collarbone.

If you think there are any changes, or if you have any concerns, see your doctor.

Discuss with your surgeon how often in your case there should be monitoring over the longer term.

No symptoms

In the absence of symptoms, doctors don't recommend removing your breast implants. This is because BIA ALCL is a rare cancer with excellent cure rates if it is detected early.

The risk of developing BIA ALCL is lower than the risk of anaesthesia and surgery. Revision surgery that involves implant removal or replacement has a higher complication rate.

Generally, breast implants are not lifetime devices, regardless of breast implant associated cancer. After 10-15 years, they're usually removed. The longer you have the implant, the more likely it will need to be removed. A hard or painful implant or movement are the most common reasons for removal.

Breast implant associated cancer is rare. The risk is higher with certain types of breast implants. If you can't remember whether your implants are smooth or textured, or what brand they are, ask your surgeon or the clinic that holds your record.

If you're healthy, talk to your surgeon about the pros and cons of removing implants. You can also discuss a plan for regular check-ups. You can also seek a second opinion. This could help you if you are unsure or concerned about the advice you receive from your surgeon.

No matter what brand or texture of implant you have, or if you have had them removed, you should regularly check your breasts and talk to your doctor if you notice any changes.

Medicare benefits for tests and treatment

Medicare covers investigations and treatments for breast implant-related cancers.

MBS item 63547: MRI investigation of patients diagnosed with BIA-ALCL.
MBS item 45551: Removal of each breast implant and its capsule.

For lymph node procedures and for other types of breast surgery, MBS items are available. Your surgeon will choose what's right for you based on the procedure.

Report problems

We monitor the safety of medical devices in Australia. This includes breast implants. If you experience a problem or side effect following a breast implant procedure, report it to us.