On the Coast – Over 55 Issue 31 I September/October 2019 | Page 6

Breast Implant Cancer
With Dr Mary Ling, Central Coast Breast and General Surgeon
Have you had implants for breast reconstruction or augmentation?
The recent worldwide recall of the Allergan brand of implants due to
their links to a rare form of cancer has raised many questions. Here are
answers to 6 frequently asked questions...
Our implant story
Empire Bay theatre nurse Janis
Livingstone, 67, was diagnosed with
hereditary breast cancer in 2001.
Her daughter, Sarah, was diagnosed
with breast cancer in 2015.
What is Breast Implant Associated
Anaplastic Large Cell Lymphoma
(BIA-ALCL)?
BIA-ALCL is a rare cancer of the immune
system that occurs in people who have
had breast implants. It is not breast
cancer, but rather a type of lymphoma
that grows in the scar tissue (capsule)
surrounding the implant.
What is the risk?
The risk of BIA-ALCL is estimated to
be between 1 in 1000 and 1 in 10000,
meaning 1 woman will be diagnosed
with BIA-ALCL for every 1000 to 10000
women with breast implants.
The risk is significantly higher for
“macro” textured (e.g. Silimed
Polyurethane, Allergan Biocell) compared
with “micro” textured (e.g. Mentor Siltex)
implants. All Australian cases have
occurred in women with textured
implants (and no cases in women with
smooth implants).
There is no difference in risk in
women who have implants for breast
augmentation or reconstruction.
BIA-ALCL occurs with both saline and
silicone filled implants.
What are the symptoms?
The main symptoms of BIA-ALCL are
persistent breast swelling or pain. It can
also present as a lump in the breast or
armpit. Most cases occur between 3 and
14 years after surgery.
How is it diagnosed?
An ultrasound is performed to assess for
the presence of fluid. If fluid is present, a
sample will be taken to look for
cancerous cells. Fluid collection is
common after breast implants and most
are not BIA-ALCL. Mammograms are not
helpful for the diagnosis.
What is the treatment?
Most patients with BIA-ALCL are
cured by removing the implant and the
surrounding capsule.
Should implants be removed,
“just in case?”
It is currently not recommended that
breast implants are removed in people
without any symptoms. However,
breast implants are not lifetime devices
regardless of BIA-ALCL. Please discuss
with your surgeon about regular implant
checks or if you have concerns.
“I originally had implants, but they
started to encapsulate last year
(become hard and misshapen). I also
knew a lady with breast implants
who developed ALCL and I chose
to have them removed and have a
TRAM-flap instead (own tissue from
abdomen),” says Janis.
However, Sarah, who was treated
with a 9 cm aggressive lobular
cancer, opted for breast implants.
“I’m comfortable with my decision
because I am regularly monitored
and trust my surgeon.”
Scan the QR code below to
watch Janis & Sarah share
their breast cancer journey

For updates, visit the Breast Implant Hub
by Therapeutic Goods Administration
www.tga.gov.au/hubs/breast-implants
Dr Mary Ling is a Breast and General Surgeon who consults at Gosford, Woy Woy and Kanwal.
www.drmaryling.com.au
@drmaryling
& 02 4321 0302
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O N T H E C OA S T – OVER 5 5