BRCA Mutations Up Risk of Rare Lymphoma in Women With Textured Implants

Breast-implant associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare type of lymphoma linked to textured implants. New research shows that women with a history of breast cancer and a BRCA mutation who had reconstruction with textured implants are 16 times more likely to develop BIA-ALCL than women without a BRCA mutation.

The researchers emphasized that the average risk of BIA-ALCL is low overall. But they noted that having a BRCA mutation seems to dramatically increase that risk.

The study included more than 3,500 women who opted for breast reconstruction with textured implants after they had mastectomy for breast cancer; 520 of the women had genetic testing.

Overall, among the more than 3,500 women with textured implants, 11 developed BIA-ALCL.

Among the 520 women who had genetic testing, seven developed BIA-ALCL during about 11.5 years of follow-up. The researchers found that 43 of the women had a BRCA mutation. Women with a BRCA mutation were 16 times more likely to develop BIA-ALCL than women without a BRCA mutation.

The researchers also did what’s called a case-control study that compared 13 women with implants and BIA-ALCL and a control group of 39 women with implants and no BIA-ALCL. Five of the 13 women with BIA-ALCL had a BRCA mutation compared to three of the 39 women in the control group.

The U.S. Food and Drug Administration doesn’t recommend having implant removal surgery unless you’re having symptoms, which include pain, lumps, swelling, or unexpected changes in breast shape. The researchers urged women with a history of breast cancer and implants to have open discussions with their doctors about the type of breast implants they have and steps they can take to minimize any BIA-ALCL risk.

“The implants that are put in place now are theoretically safe; however, there are still a lot of women who are living with textured breast implants, so it’s important that women know what implants they have and talk with their doctor and remember to report this surgery as part of their medical history,” lead author Paola Ghione, MD, lymphoma specialist at Memorial Sloan Kettering Cancer Center, said in a statement.