The placement of breast implants can, in rare cases, cause the appearance of anaplastic lymphoma according to the Medicines Agency. List of risks, prostheses concerned and reminder of the follow-up to be observed for women.
[Mis à jour le 27 janvier 2023 à 12h41] breast implants have been withdrawn from the French market in 2019due to an increased risk of developing anaplastic large cell lymphomaa type of very aggressive blood cancerrecalls theNational Medicines Agency (ANSM) in a press release dated January 26, 2023. Since then, the Agency scans all models of implants as soon as they are notified of marketing in France. This control allows check that no new implant marketed has a texture similar to those that have been banned in 2019.
Which breast implants are associated with the risk of lymphoma?
In 2019, the ANSM took the decision “to withdraw from the market breast implants (with an outer surface in macrotextured silicone) and polyurethane-coated surface implants“, as a precautionary measure and in view of all the information available to it. prostheses and tissue expanders from the Microcell and Biocell ranges of the Allergan brand which are now prohibited in France. For the other implants currently on the French market, there is no (according to the ANSM) any elements indicating an increased risk of the appearance of anaplastic lymphoma.
What are the risks with these breast implants?
“The placement of textured breast implants induces a certain number of known and described risks, among which anaplastic large cell lymphoma related to breast implants (LAGCAIM)is it specified in the opinion of the ANSM. The more the implant is textured and rough, the greater the risk of occurrence of anaplastic lymphoma.“. As well, the risk of adverse effects increases with the duration of wearing the implants. As of January 17, 2023, the ANSM has recorded 103 cases anaplastic lymphoma with large cells associated with a breast implant in France of the 400,000 women who wear prostheses breasts. About a third of the cases concern prostheses implanted for more than 10 years, sometimes 30 years ago. ButNational Cancer Institute (Inca) is nonetheless reassuring:“If there is a proven link between the occurrence of this pathology and the wearing of a breast implant, the frequency of this complication remains rare“. There are still many questions, especially concerning the possible causes of the appearance of this pathology.
What is anaplastic lymphoma?
Anaplastic lymphoma is a rare formbut aggressive blood cancer, which is usually manifested by an effusion of fluid around the prosthesis. This cancer develops from a type of white blood cells present in the lymphatic system: T cells. The disease affects the lymphoid organs such as the lymph nodes or the spleen, sometimes with skin manifestations.
What are the symptoms to watch out for if you have breast implants?
Women should be aware of the clinical signs suggestive of a breast abnormality:
- a so-called “periprosthetic” effusion (accumulation of a clear portion of any bodily fluid in a tissue or organ)
- breast enlargement
- a mass at the level of the prosthesis
- breast pain
- inflammation and ulceration
- sometimes, an alteration of the general state with fever.
► If these symptoms”occur in particular at a distance from the postoperative phase in a woman with a breast implant”he need to see a doctor, recalls the ANSM. “He is recommended to perform an ultrasound. If this examination is not sufficient, an MRI is recommended as a second intention, specifies the agency. Anyway, as a precaution, it is important that the person implanted is regularly monitored by a doctor“, even in the absence of symptoms in order to check the condition of the prosthesis.
What are the recommendations for women?
The Medicines Agency has issued its recommendations regarding the use of textured breast implants:
► In the context of reconstructive surgerythe use of textured implants is not recommended, but remains indicated in a certain number of situations in which the texture of the implant constitutes a proven benefit (in terms of anatomical shape, stability, tissue expansion and reducing the risk of adhesive capsulitis).
► In the cosmetic surgery settingthe use of textured implants is not essential, but can remain one option among others in a certain number of situations in which the texture of the implant constitutes a proven benefit (in terms of stability, tissue expansion and reducing the risk of adhesive capsulitis).
► In the context of the recommendation made by the ANSM to preferably use breast implants with a smooth shellit is better to “to prohibit the use of Allergan’s Biocell texture“, including breast implants of equivalent textures and polyurethane implants.
► Given the rarity of the risk of occurrence of anaplastic lymphoma, the ANSM does not recommend preventive explantation (in other words, to withdraw as a preventive measure) the macrotextured implant and the implant with a surface covered with polyurethane.
Sources: ANSM publishes new data on the monitoring of breast implants, January 26, 2023 / Anaplastic large cell lymphoma: a lead for the treatment of resistant forms, INSERM