You may have heard that some people with breast implants may have a very low risk of developing a kind of cancer called anaplastic large cell lymphoma. There are several different kinds of anaplastic large cell lymphoma. When associated with breast implants, this lymphoma is called breast implant–associated anaplastic large cell lymphoma, or BIA-ALCL. It can occur in people who chose breast implants for cosmetic reasons as well as people who received implants during reconstructive surgery after cancer.

If you or someone you love has breast implants, learning more about the disease can help you feel better prepared if you decide to speak with a doctor. This is a good place to start.

What is breast implant–associated anaplastic large cell lymphoma (BIA-ALCL)?

BIA-ALCL is a rare form of cancer. Studies show the number of people who develop this disease is between 1 in 1,000 and 1 in 40,000 people with breast implants. BIA-ALCL starts in the fluid or scar tissue directly around an implant and, in rare cases, also grows to involve the skin around the implant or lymph nodes. It is not a kind of breast cancer, but rather a type of non-Hodgkin lymphoma — a cancer of the immune system.

Most people with implant-associated BIA-ALCL are successfully treated and cured. However, the US Food and Drug Administration has reported a small number of deaths linked to BIA-ALCL.

What type of implant causes breast implant–associated anaplastic large cell lymphoma (BIA-ALCL)?

BIA-ALCL has been reported with both silicone gel and saline implants. While the disease is rare, it appears to occur most frequently in people with implants that have a textured surface versus implants with a smooth surface. In July 2019, Allergan’s textured breast implants and tissue expanders were recalled from the market. This means that these implants are no longer sold in the United States. However, the US Food and Drug Administration is not recommending that people have textured implants removed or replaced. Talk with your MSK care team if you want more information about textured implants.

What are the signs and symptoms of breast implant–associated anaplastic large cell lymphoma (BIA-ALCL)?

The most common sign is fluid around the implant. This usually happens several to many years after the implant was originally placed. The breast is usually swollen and may also become lumpy or misshapen with tightening or scar tissue around the implant.

Less commonly, BIA-ALCL can also cause tumors in the breast skin or enlarged lymph nodes in the armpit. These signs do not necessarily mean a person has BIA-ALCL. Other problems, most commonly a ruptured silicone implant, may also result in the development of the same symptoms. However, if you have any of these symptoms, it’s important to see a doctor.

How is breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) diagnosed?

To diagnose BIA-ALCL, a doctor may order an MRI, PET scan, or ultrasound to evaluate the scar tissue and fluid around the implant. Tissue or fluid samples may also be taken for testing.  

How is breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) treated?

The treatment for BIA-ALCL is usually surgery to remove the implant and the scar tissue around the implant. This treatment is the only therapy needed for most patients. Some people also need chemotherapy or radiation therapy, but that is less common.