Anaplastic Large Cell Lymphoma (ALCL) associated with breast implants is a very rare cancer. It is gaining attention in the plastic surgery news and general media. This is an ALCL update in part based on a report from the American Society of Plastic Surgeons (ASPS).

ALCL is a lymphoma, a cancer associated with lymphatic system. When caught early, it is a very treatable problem. It is worth noting that this is different from breast cancer; ALCL is not a cancer associated with breast tissue and its treatment is different from that of breast cancer.

How does ALCL present?  Typically it occurs in people who have had breast implants for awhile (average 8 years) and have swelling of the breasts. Confirmation is usually done with ultrasound guided drainage and cytology. The treatment may involve implant removal, capsulectomy and possibly chemotherapy.

As of July of 2018, there have been a total of 230 cases reported to the registry known as PROFILE. At  first glance, this may appear to be a significant number. However, keep in mind that 300,000 cosmetic breast augmentation and 150,000 breast reconstruction are performed every year. The incident of this disease is very small indeed and no screening protocol is advocated.

Now, there is the good news. According to ASPS, ALCL appears to develop exclusively in women who have or have had textured implants. There appears to be no difference in silicone vs saline implants. For primary breast augmentation, I have exclusively used smooth implants in my practice for over 20 years.

We are still learning more about ALCL and all patients should be aware of ALCL, even though the incidence is very low. In our practice, we continue to stay away from textured implants in cosmetic breast augmentations and continue to educate our patients about this entity. Stay tuned for another ALCL update as further information becomes available.