Breast Implant-Associated Lymphoma: Do I Need to be Concerned?

Women who undergo a mastectomy have many options and concerns to consider when going through breast reconstruction. My choice was simple — I wanted to look as natural as possible. I had never had implants and was a natural C/D-cup which I hoped to maintain without it appearing as though I had implants following reconstruction. The results were incredible and I have been cancer-free, but I have recently had some complications around my right breast. It has left me wondering if I made a mistake in choosing a textured implant.

I felt fortunate at the time to benefit from the latest advancements in surgery and products available when I made my choices for reconstruction. I opted for a nipple and areola sparing double mastectomy with a natural, teardrop-shaped silicone implant. The procedure was complete following a fat transfer to fill around the implant. One bonus is that sensation in both breasts and some sensation in my nipples has returned.

What I have since learned, however, is my choice in selecting a natural-shaped implant means that I have a textured implant. I had no idea at the time there was a difference in smooth versus textured implants, as my choice was based on how the implants would look in my body. It has since been explained to me the implant is textured as a way to keep it in place and from moving around.

Around November of 2018, I began to develop tenderness and swelling around my right breast. My right breast also began to feel heavy and I initially feared a recurrence. There were also times I felt swelling were three lymph nodes were taken under my right arm. I had myself checked out and while my surgical oncologist was not worried, he ordered an ultrasound and wanted me to follow up with my plastic surgeon. An ultrasound showed there was a fair amount of fluid that had collected around my right breast. A needle biopsy was scheduled to drain the fluid, but I found I was able to successfully drain the fluid using some yoga-for-cancer moves, which I am trained in (as well as the support of a lymphatic drainage massage). I now just experience discomfort around the area where my lymph nodes were taken. I have to say, I had wondered in the back of my mind if my implants could be contributing to complications.

During my annual check-up with my regular oncologist and follow up with my plastic surgeon, I have been given reassurance that it would not appear I am having any complications linked to having a textured versus a smooth implant. The complication I am referring to is the rare potential link to Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). My oncologist shared there are no current signs of anything other than my body likely having had a reaction to fighting a virus back in November. A good sign they both agreed upon is the fact the fluid successfully drained away from my implant. I will be monitored and seen in another six months by my oncologist, but what I was told they will be looking for would be a hardness around the right breast, continued swelling or fluid retention (which, if it were to reoccur, would be tested with a needle biopsy) and misshapen breasts, among other symptoms.

I was relieved to feel I have not been evaluated to have the beginnings of BIA-ALCL, but it is good for women who may have concerns to follow up with their oncologists and/or plastic surgeons annually, even if they are no longer undergoing other care or treatment. It was explained to me now that there is a baseline for the feel and look of my breast, surveillance will be provided by having no less than one annual check-up of my overall breast health. Other factors which warrant an annual check-up can simply include monitoring the health of any implant used during reconstruction and is not contingent upon the implant being textured or smooth.

As a side note to my peers, I am not an expert in anyway in regard to BIA-ALCL, but it seems there is community concern regarding this diagnosis. So, the best advice I can give is to see your medical professional and maintain open communication to ease concerns and monitor your health with no less than an annual check-up. A medical professional who is familiar with your history and breast health can evaluate annually for any concerns or general changes, which may warrant a scan or other testing to rule out potential complications. I have at least been told BIA-ALCL is not something either of my physicians feel I should have a concern with at this time, but any recurrence of fluid around my breast could trigger a concern for further evaluation. I will personally confess that once it is time to replace the implants, I will likely opt for a complete fat transfer to shape my breasts and continue to maintain a natural look without some of the worry of smooth or textured implants altogether.