Silicone Implants/ Lymphoma
http://www.nlm.nih.gov/medlineplus/news/fullstory_71206.html
Reuters Health
Tuesday, November 4, 2008
NEW YORK (Reuters Health) - The results of a new study suggest that silicone breast prostheses may increase the risk of developing a rare form of lymphoma - cancer of the lymph system. However, the authors emphasize that because anaplastic large T-cell lymphoma (ALCL) of the breast is so rare, the absolute risk is still very low.
Dr. Daphne de Jong, from The Netherlands Cancer Institute, Amsterdam, and colleagues evaluated the association between silicone implants and this cancer after identifying two patients who had ALCL in the fibrous capsule surrounding their silicone breast implants. Although similar cases had been reported in the literature, no formal studies have examined the topic.
A search of a Dutch pathology database identified 11 women (average age of 40 years) who were diagnosed with ALCL of the breast from 1990 to 2006. Each patient was matched by age and year of diagnosis to one or more women with other types of lymphomas in the breast (the control group).
Five of the ALCL patients had received silicone implants in both breasts 1 to 23 years prior to diagnosis, the authors report in the Journal of the American Medical Association for November 5th. In all five women, the implants were placed for cosmetic reasons.
The most common lymphoma in the control group was diffuse large B-cell lymphoma, followed by mucosa-associated lymphoid tissue-type lymphoma. Just 1 of the 35 control patients had a breast implant prior to their lymphoma diagnosis.
"The odds ratio for ALCL in the breast associated with silicone breast prosthesis placed for cosmetic reasons was 18.2," the investigators calculate.
As noted, though, the absolute risk of ALCL with silicone breast implants is exceedingly small. The authors calculate that just 0.1 to 0.3 cases per 100,000 women with implants would arise per year.
"These findings must be considered preliminary and hypothesis-generating and are not strong enough to definitively conclude that breast implants predispose women to non-Hodgkin lymphoma," Dr. Andrew M. Evens and Dr. Brian C.-H. Chiu, from Northwestern University, Chicago, write in an accompanying editorial.
"However," they add, "given that silicone is immunogenic, further evaluation of breast implant-related lymphoma is warranted, particularly by studies with statistical power, sufficient follow-up, and information on other factors."
JAMA 2008;300:2030-2035,2059-2061.
Comments
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From my understanding, the anaplastic large cell lymphoma is related to the textured form stable implants. Unfortunately, like mine.
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National news broadcast that all implants are going to have to have black-box warning. Seems it doesn't matter if they are smooth or textured; saline or silicone, they all increase the risk. At least the information is out there and it may help women who are on the fence with decisions.
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There are more than a few threads already covering this issue on BCO. This article is from 2008 and there have been many in the last few months with more news today as Wallycat mentioned. The Allergan textured implants on the shelves were recalled, but no comments were made about 'explanting' implants in people.
Obviously we should be aware, but I read the 30+ pages of small print warnings that came with the implants before I ever decided to have the surgery so I was not surprised. Now from reading everything I can find, talking to my plastic surgeon & having a thorough exam, and having a diagnostic ultrasound last week, I'm putting my worries to bed for now and moving on.
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MinusTwo, they reported that the conditions of secondary blood cancers is rare and yes, not to run out and have them removed, though they did report a huge push on removal surgeries in some areas.
Blood labs are about the only way to keep tabs on this, which most people do anyway as routine physicals.
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