The Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand Confirms the Highest Risk for Grade 4 Surface Breast Implants

Plast Reconstr Surg. 2019 May;143(5):1285-1292. doi: 10.1097/PRS.0000000000005500.

Abstract

Background: The epidemiology and implant-specific risk for breast implant-associated (BIA) anaplastic large cell lymphoma (ALCL) has been previously reported for Australia and New Zealand. The authors now present updated data and risk assessment since their last report.

Methods: New cases in Australia and New Zealand were identified and analyzed. Updated sales data from three leading breast implant manufacturers (i.e., Mentor, Allergan, and Silimed) were secured to estimate implant-specific risk.

Results: A total of 26 new cases of BIA-ALCL were diagnosed between January of 2017 and April of 2018, increasing the total number of confirmed cases in Australia and New Zealand to 81. This represents a 47 percent increase in the number of reported cases over this period. The mean age and time to development remain unchanged. The implant-specific risk has increased for Silimed polyurethane (23.4 times higher) compared with Biocell, which has remained relatively static (16.5 times higher) compared with Siltex implants.

Conclusions: The number of confirmed cases of BIA-ALCL in Australia and New Zealand continues to rise. The implant-specific risk has now changed to reflect a strong link to implant surface area/roughness as a major association with this cancer.

MeSH terms

  • Adult
  • Aged
  • Australia / epidemiology
  • Breast Implantation / adverse effects*
  • Breast Implantation / instrumentation
  • Breast Implants / adverse effects*
  • Female
  • Humans
  • Lymphoma, Large-Cell, Anaplastic / epidemiology*
  • Lymphoma, Large-Cell, Anaplastic / etiology
  • Middle Aged
  • New Zealand / epidemiology
  • Polyurethanes / toxicity
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Risk Assessment
  • Surface Properties
  • Young Adult

Substances

  • Polyurethanes