Q & A Library

The U.S. Food and Drug Administration (FDA) has reported that breast implants - both silicone and saline - are associated with a "very small but significant" increased risk of a very rare type of lymphoma, a malignancy affecting the lymphatic system. The good news is that this type of cancer is treatable; sometimes, all that's required is removal of the implants and surrounding scar tissue, although some affected women also need chemotherapy and radiation. The increased risk applies to women who have had implants for breast reconstruction after cancer surgery as well as those who have had the implants for cosmetic reasons.

This type of cancer, anaplastic large cell lymphoma (ALCL) is usually an illness affecting many areas of the body, but according to the FDA in the cases linked to breast implants it tends to be localized, usually inside the scar tissue that forms around implants. The cases came to light because of such symptoms as lumps, pain, asymmetry of the breasts, fluid build-up, and swelling, all of which developed long after the implants were put in place. No one knows how or why implants increase the risk of ALCL.

So far, only 60 cases of ALCL linked to breast implants have been reported, a very small fraction of the millions of women worldwide who have them. When breast implants are not involved, only three cases of ALCL in the breast occur per 100 million women.

The FDA has made no move to limit the marketing and use of breast implants but has urged women to seek medical care if they notice any changes in their implants or develop any of the symptoms listed above. As for removal of breast implants to eliminate the added risk they pose, we have no evidence that this is effective. Cost is also a consideration. If you had the implants put in as a cosmetic procedure, I doubt that the cost was covered by your health insurance. The same will probably apply to their removal. Insurance carriers are unlikely to pay for it unless the surgery is medically necessary and the implants were part of breast reconstruction following a mastectomy.

Andrew Weil, M.D.