Updated information regarding BIA-ALCL from Dr Daniel Fleming

Dr Fleming is an acknowledged expert in BIA-ALCL. He is a member of the TGA’s Expert Advisory Panel, Chair of the Australasian College of Cosmetic Surgery’s BIA-ALCL Safety Committee, has published peer reviewed literature about the disease and advises the Australian Breast Device Registry.

Following the media coverage in the Sunday Telegraph, A Current Affair and elsewhere, patients with non-smooth breast implants may be worried. As has been seen many times before, the media coverage has tended to sensationalise the issue and as a result cause anxiety for patients that is disproportional to the real risk.

These are the facts;

  • If you do have these implants the risk to you remains very small.
  • The risk of getting BIA-ALCL is estimated to be between 1 in 1000 to 1 in 2500. These are the TGA figures released in 2016 and the new data from the Macquarie research group is consistent with this – it does not change them.
  • To put this into perspective, the lifetime risk for any Australian woman of getting breast cancer (with or without implants) is 1 in 8 and the risk of any Australian of
    developing a lymphoma in their lifetime in 1 in 50.
  • A peer reviewed paper published in the journal Aesthetic Plastic Surgery also helps to put the risk into perspective. This showed the risk of death from skiing for one day was twice as high as having textured breast implants and the risk of driving for 8 hours was 40 times higher. Click here for further information about the paper and here for a video of the authors explaining their findings.
  • Regarding the risks for specific brands of implants, there are many variables and uncertainties in the data.  Not too much should be read into these estimates and they will almost certainly change in the future. It is important to note that even on the highest estimates, the risk is still less than 1 in 1000.
  • It is increasingly believed by researchers that the vast majority of women in whom these cells are found, have a version of the condition that does not behave like a cancer but remains benign. Here is a link to a recently published peer-reviewed paper the respected journal Aesthetic Plastic Surgery which explains the evidence for this. Dr Fleming was the lead author of this paper. Consistent with the paper’s findings, the Macquarie researchers have also found that in 60% of patients who are diagnosed with BIA-ALCL, no evidence of cancer can be found when they have their implants removed. The researchers in the video link above also support the view that most patients have a non-malignant version of the disease.
  • If you are considering breast implant surgery, you should be made aware that different implant surfaces have different complication rates and decide with your surgeon which type of implant is best suited to your individual circumstances.
  • The advice of the College of Cosmetic Surgery, and that of the TGA expert advisory panel on which the College is represented, is that unless you have symptoms of a new enlargement of the breast or a breast lump there is no cause for concern or any need for a scan or other investigation.
    If you do have a lump or swelling of the breast, or if you have further questions, you should contact your surgeon. This applies for all types of breast implants.

Hopefully this update has helped you understand BIA-ALCL better and put the very small risk into perspective. If you have any questions please contact us.