Lymph node cancer very rarely occurs with an artificial breast

All plastic surgeons register their operations with breast implants in the Dutch Breast Implant Registry DBIR

Early detection and treatment of breast implant-associated anaplastic large T-cell lymphoma (BIA-ALCL) is highly feasible and essential to achieve a good survival rate (90-95%).

Mintesje de Boe’s PhD research identifies the risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). De Boer, a doctoral student and plastic and reconstructive surgeon in training at Maastricht UMC+, shows that women who have breast prostheses are more likely to develop this disease than women who do not have a prosthesis. However, the absolute chance of a woman with a breast prosthesis before her seventy-fifth year getting sick is extremely small: 1 in 7,000. Doctoral research has provided important information about various aspects of BIA-ALCL, which has been used to formulate global policy on BIA-ALCL and to inform patients as optimum. This letter demonstrates how important multidisciplinary cooperation and good registration of breast prostheses are to monitor understanding of prosthetics and related complications, as in the Netherlands by the Dutch BIA-ALCL Consortium and the Dutch Breast Implant Registry (DBIR).

Patient information comes first
BIA-ALCL is a form of lymphoma that occurs in the fluid or capsule surrounding a breast prosthesis. De Boer: “Women choose breast prostheses for very good reasons, and for most women, it greatly increases their quality of life. In the Netherlands, 1 in 30 women have breast prostheses. This is almost 200,000 women in the Netherlands. The De Boer study provided the basis for adequate patient information for these women.” “The risk of BIA-ALCL is very small (1 in 7,000 before the age of 75), so there is no need to panic in women with breast prostheses. By comparison, the chance of developing breast cancer in the Netherlands is about 1 in 7. We tell women that if the breast becomes larger with a breast prosthesis, or if a lump can be felt, it is important to investigate this further.” Research In practice, plastic surgeons are also more aware of the symptoms of BIA-ALCL, so that the disease is often caught at an early stage.Full recovery for 90-95% of women can be achieved with early appropriate treatment.

future research
The research was conducted by the Dutch multidisciplinary BIA-ALCL consortium, which consists of plastic surgeons from Maastricht and Twente, epidemiologists and hematologists from Anthony van Leeuwenhoek and pathologists from Amsterdam UMC and with support from the Dutch Society of Plastic Surgery (NVPC). Member of the Research Consortium Dr. Rene van der Holst of MUMC+ stresses the importance of the findings, but also notes that not all questions have yet been answered. “We don’t yet know why women with breast prostheses get BIA-ALCL. For example, there is some evidence that women with an increased genetic risk of breast cancer have an increased risk of BIA-ALCL, but our rather small study in this Domain not confirmed by others.

The importance of good recording
What was also emphasized in the letter is the great importance of the breast prosthesis registration to monitor for complications related to the prosthesis. In the Netherlands there is a DBIR (provided by the NVPC) for this. This record is unique in the world. All plastic surgeons register their operations with breast implants at DBIR. DBIR monitors for insight into quality and related complications. In addition, the DBIR system enables patient tracking when recall is required. “The monitoring of good registration in DBIR and the information we can get from this will provide reliable information in the future and make it possible, for example, to identify prosthetics where BIA-ALCL is less common,” says de Boer.