Breast implants may cause a new subtype of anaplastic large cell lymphoma (ALCL), an international research group reports in the journal Mutation Research.
Across the globe, there have been 71 documented cases of patients with ALCL in which breast implants may play a causal role. ALCL is typically found in the lymph nodes, as well as in the skin, lung, liver and soft tissue, but not the breast. Cases in which ALCL developed in the breast region almost exclusively involved patients who had breast-augmentation surgery.
Exactly how, or even if, breast implants can cause lymphoma remains unclear. Moreover, this is an extremely rare cancer. Among three million breast implants, there are between one and six reported cases of ALCL.
According to the new findings, the average patient is 50 years of age, and most cases present in the capsule surrounding the implant as part of the periprosthetic fluid or the capsule itself about 10 years postsurgery, suggesting that the cancer is a late complication.
A New Subtype of ALCL?
ALCL is divided into two subtypes. In one subtype, the cancerous cells produce an abnormal form of the protein ALK (anaplastic lymphoma kinase). The other type does not express ALK in tumor cells at all. The cancer is considerably more aggressive in ALK-negative cases.
Breast implant-related ALCL may form a third group. The cells do not express ALK, but patients have good survival rates. “This is a previously unrecognized, new subtype of ALCL,” says study author and pathologist Lukas Kenner from the Medical University Vienna, the University of Veterinary Medicine and the Ludwig Boltzmann Institute for Cancer Research, both in Vienna. “We must now determine the exact causes behind its occurrence.”
While some patients were successfully treated with chemotherapy and radiation therapy, the lymphoma in many cases subsided on its own following removal of the implant and the surrounding tissue. An abnormal immune response from the body could therefore be a cause of the cancer, the study authors suggest. Kenner and his team are now preparing for further studies in which implants and dentures will be examined in other parts of the body.
The study was funded by the British organization Leukaemia & Lymphoma Research.