The topic of breast “implant related illness” has been discussed for many years. Recently, I have seen more people in consultation concerned with this issue. This current increase is possibly fueled by more attention given to the subject by clinical practitioners, other patients and the media. Dr. Rod Rohrich et al recently published an article in Plastic and Reconstructive Surgery addressing this issue; my own experience of over 20 years has closely mirror the findings of their report.
Anaplastic Large Cell Lymphoma
Much of the discussion has been reenergized by the recent reporting about anaplastic large-cell lymphoma (ALCL). ALCL is a rare non-Hodgkin’s lymphoma associated with breast implants. There has been about 180 ALCL cases reported so far in the United States. Since there are about 30 million U.S. women with breast implants, this is a relatively small number, especially compared to the usual breast cancer, which occurs in one in ten women. Over 99% of ALCL cases have been associated with textured implants. I use smooth (non-textured) implants in essentially all patients. The current recommendation from the CDC, FDA and American Society of Plastic Surgeons do not include removal of asymptomatic textured implants.
Other Cancer Risk
In multiple extensive studies so far, there has been no increased risks in the incident of ductal or lobular carcinoma (the most common types of breast cancer) in women with either silicone or saline implants.
Connective Tissue Disease/Autoimmune Disease
For many people, connective tissue and autoimmune diseases are probably what comes to mind when they think of implant related illness. Sjogren’s syndrome, rheumatoid arthritis, sarcoidosis, lupus and polymyositis are some diseases that have been studied. So far there have not been conclusive evidence to suggest any causal relationship.
In conclusion, multiple large studies have provided us with a convincing record of implant safety. Additional research is currently underway on ALCL. Ultimately, the patient must make her own decision. However, I strongly recommend a thorough personal discussion with a board certified plastic surgeon to weigh all the factors involved.