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What is ALCL and how does it relate to implants?

Anaplastic large cell lymphoma is a cancer of the immune system. ALCL is not a form of breast cancer, but develops in the scar tissue around the implant, eventually leading to fluid build-up within the fibrous capsule. It is believed that BIA-ALCL is triggered by the body responding to foreign material, but the cause is not yet fully established. BIA-ALCL has been documented in both breast reconstruction and cosmetic breast augmentation patients who had textured Allergen saline and silicone implants or tissue expanders.

How is ALCL diagnosed?

The first step in diagnosing ALCL starts with identifying the symptoms. These symptoms include:

  • Enlargement of the breasts
  • Breast pain
  • Lump, or lumps, within the breast or the armpit
  • Asymmetry of the breasts
  • Breasts feeling firmer than usual or hard
  • Skin rashes or irritation

When symptoms associated with BIA-ALCL are present you will then undergo a physical examination and testing. These symptoms can be associated with another issue and may not indicate BIA-ALCL. Testing may include an ultrasound or MRI. If lumps or fluid are identified around the implant or within the lymph nodes, fluid will be extracted from around the breast to test for the presence of BIA-ALCL.

How is ALCL treated?

Once a diagnosis of ALCL, or BIA-ALCL, is made, you will be referred to an oncologist. A PET or CT scan will be performed to determine the extent of the disease and what treatment is necessary. If the BIA-ALCL is localized around the implant, surgery can be performed to remove the implant and the fibrous scar capsule. Other tests or biopsies may be necessary. In cases where the disease has spread beyond the fibrous capsule, chemotherapy treatment, along with the removal of the implant and scar tissue, is performed. In some rare cases, radiation or other therapies may be part of the treatment.

What should I expect after treatment?

After the removal of your implants and any prescribed treatment, it is common to follow up with your oncologist over the next two years. During this time, routine imaging and testing will be performed to ensure that you remain free of the disease. Re-occurrence of ALCL is very rare after the surgical removal of the implants.

BIA-ALCL is typically resolved by removing the textured implants if identified in the early stages. The condition usually develops several years after breast augmentation with the specific types of Allergan implants, in the Natrelle line.

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Why should I choose Dr. Wirth at Wirth Plastic Surgery?

Garrett Wirth, MD, MS, FACS prioritizes the health of his patients above all else. Dr. Wirth aims to help monitor your health and address any concerns that may arise about your current implants. Monitoring your breasts for undesirable changes and scheduling regular check-ups to assess the health of your breasts and the integrity of the implants is the best way to ensure your health and wellness.

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