Although the absolute risk remains small, breast implants have been associated with an increased risk of anaplastic large-cell lymphoma in the breast (breast-ALCL) among women, according to a study published in JAMA Oncology

The safety of breast implants has not been confirmed despite widespread use; previous studies have presented conflicting data regarding the risk of various adverse events such as breast cancer, autoimmune disease, connective tissue disease, and breast-ALCL.

For this case-control study, researchers accessed the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA) and identified 782 patients with non-Hodgkin lymphoma of the breast, which was then further narrowed to 43 women with primary breast-ALCL.

Of the 43 women with breast-ALCL, 32 also had ipsilateral breast implants, compared with just 1 among 146 patients with other primary breast lymphomas (odds ratio [OR], 421.8; 95% CI, 52.6-3385.2; P < .001).

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There were 28 cases for which the type of breast implant was known. Although macrotextured breast implants accounted for only 45% of all sales, 82% (23) of patients with breast-ALCL received this type of implant.

The estimated incidence of breast implants among women between the ages of 20 and 70 years was 3.3%. Further analysis revealed that the cumulative risks of breast-ALCL among women with breast implants were 29 per million at 50 years and 82 per million at 70 years. 

Study results showed that 6920 women with breast implants would increase the cases of breast-ALCL by 1 before age 75.

The authors concluded that “Our results emphasize the need for increased awareness among the public, medical professionals, and regulatory bodies, promotion of alternative cosmetic procedures, and alertness to signs and symptoms of breast-ALCL in women with implants.” 

Reference

De Boer M, van Leeuwen FE, Hauptmann M, et al. Breast implants and the risk of anaplastic large-cell lymphoma in the breast [published online January 4, 2018]. JAMA Oncol. doi: 10.1001/jamaoncol.2017.4510