From the Guidelines
Women with Nagor breast implants should be aware of the rare but potential risk of developing breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), and monitor for symptoms such as persistent swelling, pain, or fluid collection around the implant. The risk of BIA-ALCL is estimated to be low, ranging from 1 in 3,000 to 1 in 30,000 women with textured implants 1. Symptoms typically develop years after implant placement, with a median time to diagnosis of 8 to 10 years 1. If symptoms occur, diagnosis is usually made through ultrasound-guided aspiration of the effusion, followed by cytopathology smears, cell block with immunohistochemistry, and flow cytometry 1. Key diagnostic markers include CD30, ALK1, EMA, and cytotoxic granule proteins such as TIA-1, granzyme B, and perforin 1. Routine removal of Nagor implants is not recommended for asymptomatic women, but regular follow-up with a plastic surgeon and prompt reporting of any changes around the implants is crucial for early detection and treatment 1. Treatment typically involves implant removal and complete capsulectomy, and the condition is highly treatable when caught early 1. It is essential for women with Nagor implants to be informed about the potential risks and symptoms of BIA-ALCL, and to seek medical attention if they experience any unusual changes around their implants. Some key points to consider include:
- The risk of BIA-ALCL is higher with textured-surface breast implants, particularly those made by Allergan (formerly Nagor) 1
- Symptoms may include seroma, mass, or hardening adjacent to the implant 1
- Diagnosis is typically made through a combination of clinical evaluation, imaging, and cytopathology 1
- Treatment usually involves implant removal and complete capsulectomy, and the condition is highly treatable when caught early 1
From the Research
Lymphoma and Nagor Breast Implants
- There is evidence to suggest that breast implants, including Nagor breast implants, can be associated with the development of anaplastic large-cell lymphoma (ALCL) 2, 3, 4.
- Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare T-cell non-Hodgkin lymphoma that arises around breast implants 2.
- The risk of developing BIA-ALCL is estimated to be 0.35 to 1 case per million persons per year 3.
- The incidence of implant-associated ALCL is very low, yet markedly higher than that of other primary lymphomas of the breast 3.
Diagnosis and Treatment
- Diagnosis of BIA-ALCL is usually made by cytological, immunohistochemical, and immunophenotypic evaluation of the aspirated peri-implant fluid 2.
- Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative 2.
- Late diagnosis may require more radical surgery and systemic therapies, and although these are usually successful, poor outcomes and deaths have been reported 2, 5.
Types of Lymphoma
- While ALCL is the most commonly reported type of lymphoma associated with breast implants, there have been cases of B-cell lymphoma associated with breast implants reported 6.
- B-cell lymphomas associated with breast implants are rare and not as well documented as ALCL cases 6.