Link Confirmed Between Breast Implants And Rare Form Of Cancer

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BlankLink Confirmed Between Breast Implants And Rare Form Of Cancer

20 Apr 2011

Breast implants appear to be associated with a rare form of lymphoma, but there

is not yet evidence to show that the cancer is caused by implants or to suggest

an underlying mechanism for how the disease might develop, according to a study

by researchers from the RAND Corporation.

The study, published online by the journal Plastic and Reconstructive Surgery,

also finds that the disease takes a slow course and can be controlled by

surgical removal of the implant and surrounding capsule.

The conclusions are based on an exhaustive review of the medical literature

regarding breast implants and anaplastic large cell lymphoma or ALCL, a type of

immune system cancer that was first linked to breast implants more than a decade

ago, and input from a multidisciplinary expert panel.

Concerns about an association between ALCL and breast implants were first raised

in 1996 when doctors published a report describing a woman with implants who had

developed the cancer in tissue located next to one of her implants. Since that

time, similar reports have been published, estimating that about one to three

cases would be diagnosed annually per 1 million women with implants.

Because of rising concerns, the Plastic Surgery Foundation and the Aesthetic

Surgery Education and Research Foundation commissioned RAND to conduct an

exhaustive review of the medical literature and organize a panel of medical

experts to evaluate the evidence for a potential link and its implications.

" Much more research is still needed to explore the link between breast implants

and ALCL and the clinical significance of this rare disease, but our findings

provide useful information for both patients and physicians in the near term, "

said Dr. Soeren Mattke, the study's senior author and a senior scientist at

RAND, a nonprofit research organization.

Mattke and his colleagues identified 36 published cases of non-Hodgkin's

lymphoma among women with breast implants, 29 of which were diagnosed as

anaplastic large cell lymphoma. At least 12 of the 29 women had a prior history

of a different type of cancer, including eight who had undergone mastectomy for

breast cancer and two who had a previous history of ALCL. There was no evidence

that patient risk factors or particular types of implants would increase the

risk of the disease.

While some patients received chemotherapy and/or radiation, the treatment in

most instances consisted of surgically removing the affected implant and

surrounding tissue, which appeared to successfully control the disease. No

deaths were reported among the 16 women for whom follow-up information was

available.

RAND researchers shared the review findings with a panel of medical experts and

asked them to weigh in on a series of questions related to the causes,

diagnosis, and management of anaplastic large cell lymphoma associated with

breast implants, based on their reading of the review and their own knowledge.

The panel included experts from many disciplines, including epidemiology,

oncology, immunology, pathology and material science.

The panel concluded that the evidence suggests an association between breast

implants and anaplastic large cell lymphoma, but cannot definitely prove that

implants cause the disease nor explain how the implants might trigger ALCL.

The experts recommended that the appearance of a fluid-filled sac near a breast

implant six or more months after surgery should lead to a thorough diagnostic

evaluation for anaplastic large cell lymphoma. They also concluded that the

diagnosis of anaplastic large cell lymphoma should result in a complete

evaluation to rule out spread of the disease outside of the breast capsule (the

lining that forms around the implant), followed by removal of the implant and

capsule.

Experts did not believe that disease confined to the implant capsule warrants

radiation treatment or chemotherapy after surgery and expressed the belief that

the risk of recurrence or development of systemic disease following surgical

removal was low, but that close clinical follow-up was necessary.

Article URL: http://www.medicalnewstoday.com/articles/222945.php