Decision to suspend implants may spark excessive breast cancer concern

Doug Hendrie

14/10/2019 2:05:56 PM

Concerned women with textured breast implants linked to a rare cancer are likely to seek advice from their GP, an expert has told newsGP.

Breast implant
The suspension came after around 100 cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) were reported in Australia. (Image: Donna McWilliam)

The Therapeutic Goods Administration (TGA) last month suspended all eight breast implant models listed on the Australian Register of Therapeutic Goods from being sold or used for six months over concerns of a link to a rare type of lymphoma.
Manufacturers of the implants are being given time to address safety concerns – following a TGA review of breast implants and breast tissue expanders. Two manufacturers have also pulled their products from the market.  
The move – which will affect around one in eight of all implants – came after around 100 cases of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) were reported in Australia, including four deaths.
The cancer has so far been linked only to textured implants, not smooth, and takes an average of seven to 10 years after the implant to develop.
The cancer can be treated effectively if caught early.
But the suspension is likely to arouse significant unnecessary concern among women who currently have one of the implants, according to Dr Alia Kaderbhai, Chair of the RACGP Specific Interests Breast Medicine network.
‘There will be a lot of women with these implants and no symptoms, and this will spark concerns amongst them. But, broadly, the individual risk of this lymphoma is still low,’ she told newsGP.
‘The removal of the implant is not required if there are no symptoms or concerns. The advice is to replace implants after 10 to 15 years regardless.
‘But if there is any change in the breast or armpit – swelling, lumps or pain – they need to see their doctor. The swelling can often be sudden onset.’

Dr Alia Kaderbhai wants to reassure women with implants that the cancer risk is low – but vigilance remains warranted.

Dr Kaderbhai said most cases can be treated with surgery and the removal of the implant
‘It’s important to note that this is not actually breast cancer – it’s a type of non-Hodgkins lymphoma, found in most cases in the scar tissue or fluid near the implant,’ she explained. ‘The cancer is low risk [of occurring], but it is a serious one.
The TGA states that, as the cancer is ‘very rare’, the consensus clinical advice is that removal is not required in someone with no symptoms or concerns.
Dr Kaderbhai anticipates that many women with the suspended implants in situ will want surveillance for peace of mind.
‘They may be asymptomatic, but be concerned. That needs to be done by the plastic or cosmetic surgeon,’ she said.
The Australian Society of Plastic Surgeons calls on women with implants to ‘be vigilant’ in monitoring any changes or swelling in their breasts.
‘The commonest presentation is a fluid swelling around the breast implant and in the space between the implant and breast implant capsule. The diagnosis of the tumour is made by examination of the seroma fluid,’ the society states on its website.

breast cancer breast implant lymphoma Therapeutic Goods Administration

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