Michelle Forney, 46, had her breast implants for about 19 years before she started to have problems. And then last December, she woke up one day and her breast was the size of a volleyball. She says, “Within a day it grew and just engorged.” 1After visiting her OB-GYN, who brought in a breast specialist, they determined she had mastitis (an infection). But antibiotics did nothing to help.
When she went for a mammogram, no problems were detected.
It would take several more trips to the doctor before they diagnosed her with lymphoma. And, once she was finally persuaded to have her implants removed they found “dozens of tiny tumors”2 around the implant.
Sadly, she is just one of the hundreds of breast-implant recipients who have developed a rare blood cancer called anaplastic large cell lymphoma (ALCL). According to the FDA, there are now more than 400 reports about patients who developed ALCL after having a breast implant. Nine have died.
“The FDA now believes that textured breast implants may be more likely to cause ALCL, although it says smooth implants are also linked to an increased risk. The trouble is that there’s no organized effort to put together data from people who have implants and those who have developed ALCL.
‘Many studies have looked to estimate risk and, depending on the source data and country, the global lifetime risk of developing breast-implant-associated ALCL for patients with textured breast implants ranges anywhere from 1 in 3,817 to 1 in 30,000,’ the FDA said.”3
And so, in an effort to learn more about links to the disease, the FDA is holding public hearings next year. And so is the French government. (Also, new data from Australia indicates as many as one in 1,000 people with breast implants may develop ALCL but these are different implants than are available in the U.S., something that complicates efforts to figure out the true risks.)
But another issue, as Dr. Diana Zuckerman, president of the National Center for Health Research, a nonprofit, nonpartisan advocacy organization based in Washington see it, is that women often go to multiple doctors and if they don’t communicate with each other and their medical records don’t sink up, there’s “really no way to know when women with breast implants get any number of health problems, including cancer.”4
First identified in 1997, breast-implant-associated ALCL can take about 10 years to develop (on average) after an implant first goes in. And while the disease normally stays in the area right around the implant, it can break out and spread.
“There doesn’t seem to be a difference between silicone or saline filling in the implants. There’s some evidence that making them rougher — a design meant to make the implants less likely to move around inside the breast — may raise the risk. Some plastic surgeons prefer the so-called textured version because there’s evidence it reduces the risk of capsular contracture, a common complication that can leave the breast hard and misshapen. In the U.S., textured breast implants make up about 13 percent of the market.”5
Although researchers aren’t sure why textured implants would raise the risk of cancer, there are several theories:6
- the texturing could create particles that cause abrasion, leading the body’s immune system to respond and then malfunction
- some women might just be genetically susceptible to ALCL
- bacteria could grow on the surface of the implant, causing a constant irritation that can lead to lymphoma
But the FDA says that there could be multiple factors involved in the development of breast-implant-associated ALCL like “patient characteristics, operative procedure history, breast implant characteristics including surface characteristics, and duration the breast implant is in place.”7 The FDA also cautions that while it appears textured implants have more associated risk of ALCL, that doesn’t mean that patients with smooth-surfaced implants have no risk at all.
Allergan and Mentor, makers of several types of breast implants, encourages women to speak to their surgeons about all potential risks and benefits. And Mentor links to the FDA’s warnings on its website. However, the truth is that plastic surgeons need to do a better job of educating their patients.
“We would love the FDA to require every hospital, every plastic surgeon, to send letters to every patient they put breast implants in, educating them on the signs and symptoms of ALCL. I think that every doctor that has put breast implants in any woman should be taking responsibility.”8
In 2017, 400,000 breast implant procedures took place in the US. Once you factor in the global number, the info from Australia, and the fact that little is still known about its cause, it’s time for the medical community to take this problem more seriously and perhaps time to rethink breast implants altogether. I know I’m glad I took mine out. (Check out my story below, around the 9:38-minute mark.)