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are reconstructive breast implants to blame for rising rates of rare cancer?

while study findings showed that people who received implants after a mastectomy had a higher risk than the general population of developing anaplastic large-cell lymphoma, researchers are calling it a "very rare occurrence."

women should not be "put off" of having reconstructive implants
in rare instances, alcl has been known to form in the scar tissue that surrounds a breast implant. getty
a new study has found that women who receive reconstructive implants following a mastectomy face an extremely small risk of developing a second, rarer form of cancer.

the research, published in jama network open , was undertaken by a group of researchers concerned that rising rates of anaplastic large-cell lymphoma (alcl) in recent years may be related to reconstructive surgery among breast cancer patients. the team reached a comforting conclusion for those wary of another encounter with cancer, finding that only around 12 cases of alcl are expected to occur for every one million women who undergo the surgery.

“the risk of developing alcl is actually much lower than the risk of experiencing a relapse of breast cancer,” said connor j. kinslow , lead author of the study and a resident in radiation oncology at the columbia university vagelos college of physicians and surgeons. “based on our findings, we do not believe that women should be dissuaded from having implant-based breast reconstruction after mastectomy solely due to the risk of alcl.”

anaplastic large-cell lymphoma is a rare form of t-cell lymphoma that can affect anyone at any age but is more common among women than men, according to the canadian cancer society . in rare instances, alcl has been known to form in the scar tissue that surrounds a breast implant but health agencies have been waiting for more information before drawing any conclusions.

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the current study is the first to examine the rates of alcl in breast cancer survivors who opted for implants following a mastectomy and was intended to provide patients with as much up-to-date information as possible before making a major medical decision. researchers were able to access national cancer registry data on 57,000 women who had a mastectomy with implant reconstruction for breast cancer or ductal carcinoma in situ (an early, non-invasive stage of the disease). participants had a median follow-up time of seven years and researchers kept tabs on roughly 16,000 women for at least 10 years.
although those who received implants following mastectomy did have a higher risk of alcl than the general population (who experience it at a rate of 0.3 cases per one million), the team found it to be a very rare occurrence. “among the 57,000 women in the study, only five cases of alcl were diagnosed over the combined 421,000 years of follow-up,” said david horowitz, study leader and assistant professor of radiation oncology at the columbia university vagelos college of physicians and surgeons.
the team hopes the findings provide some reassurance to anxious patients during one of the most difficult periods of their lives. “women who have had one cancer are understandably nervous about having a second,” kinslow said. “but that shouldn’t necessarily put them off from having reconstructive implants.

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“for many women, breast reconstruction after mastectomy is extremely important to quality of life and women should feel comfortable going ahead with implants without adding to the psychological burdens that come with a breast cancer diagnosis.”
dave yasvinski is a toronto-based writer.

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