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Breast Implant Review

Women who have breast implants should have regular breast implant heath checks.

If you notice any changes, have any concerns surrounding your implants or would like to book an appoinment for a review, get in touch with our team of Breast Consultants for a check-up.

Package price A (Initial consultation + Mammogram* + Ultrasound)

750

Package price B (Initial consultation + Ultrasound)

550

*Women eligible for mammograms:

  • 40 years and older and
  • haven't had their routine mammogram in the last 12 months

Breast Implant Rupture

If you showcase any of the following symptoms this could indicate a rupture of your implant and you should visit your consultant:

  • lumps or swelling in and around the breast region
  • a change in the shape of the breast
  • redness around the breast
  • pain and tenderness or a burning sensation in the breast area
  • enlarged lymph nodes in the armpit
 

BIA-ALCL

Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare type of lymphoma that is found to be associated with breast implant (silicone or saline). It is a rare sub-type of T-cell non-Hodgkin lymphoma (NHL), one of four sub-types of ALCL found in a small number of cases world-wide.

Causes of BIA-ALCL

When breast implants are placed in the body, they are inserted behind the breast tissue or under the chest muscle. Over time, a fibrous scar called a capsule develops around the implant, separating it from the rest of the breast.

ALCL is generally found next to the implant itself and contained within the fibrous capsule, hence it is thought to be associated with this coating around the implant.

It has been observed that most of the cases have occurred with women who have a textured implant as compared to a smoother one. This does not mean that those with a smoother implant are not susceptible to it.

According to the British Association of Aesthetic Plastic Surgeons (BAAPS), there is no recommendation that patients with textured implants should have them removed as a precautionary measure. If you are worried about the implant you have you are advised to visit your Consultant and discuss any concerns.

Symptoms of BIA-ALCL

If you notice any of the below signs or symptoms, you should get that investigated for BIA-ALCL:

  • Swelling
  • Pain
  • Increase in size in the breast over days or weeks

The most common symptom for BIA-ALCL is a breast lump or swelling caused by a unilateral seroma (collection of fluid) occurring between the implant surface and the capsule. Occasionally this can occur in both breasts.

 

Treatment Options

The National Comprehensive Cancer Network (NCCN) suggests that if BIA-ALCL is suspected, breast imaging is requested. If the imaging results show fluids (more than minimal) or a mass around the implant, ultrasound guided aspiration of a seroma of adequate volume is essential to test for this disease.  This is then sent for cytological (microscopic) examination to be able to make the diagnosis of BIA-ALCL and to exclude other causes.

If the tests come back positive for BIA-ALCL, the Breast Consultant advices breast implant removal. Your Breast Consultant will go through surgical treatment options best suited for you.

Total Capsulectomy

Total Capsulectomy involves first creating an insertion in the capsule and removing the implant. This is then followed by surgically removing all the scar tissue (capsule) which would include any lining that is fused along the ribs and lungs.  

En-Bloc Capsulectomy

En-Bloc Capsulectomy is a French term for ‘as a whole’. Through this surgery your breast surgeon removes the implant along with the scar tissue capsule (naturally formed as the body’s immune response to a foreign object) as a whole. The goal of this procedure is to take out the unit as a whole to protect against any silicone spillage.

In majority of BIA-ALCL cases, surgery alone is sufficient with no additional treatment required. Although, if the disease spreads over to the lymph nodes or adjacent tissues, the patient may then need radiation therapy, chemotherapy, and/or stem cell transplant therapy to manage it. This is a very rare occurrance.

 

Consultant Breast Surgeons

Miss Fiona MacNeill

MD FRCS
Consultant Breast and Reconstruction Surgeon (Oncoplastic Surgeon)

Mr Richard Sainsbury

MD FRCS
Consultant Breast and Reconstruction Surgeon

Mr Jason Lee

MD FRCS
Consultant Oncoplastic Surgeon

Miss Tena Walters

MBBS FRCS MS
Consultant Breast Surgeon

Frequently Asked Questions

PIP implants are breast implants that contained unapproved silicon gel manufactured by French company Poly Implant Prostheses (PIP). NHS states that PIP implants are 2 to 6 times more likely to rupture than standard silicone implants.

At the time of your breast implant being fitted, the details of your implants, including type and manufacturer, would be shared with you. If you don't have this information, you could get in touch with the clinic where they were fitted.

The Breast implant review consultantion would be for 30 minutes with one of our Breast Consultant Surgeons.

For the breast implant review, you will have an ultrasound and if applicable you will have to get a mammogram as well. The mammogram would only be carried out if

  • you are 40 years and older
  • you haven't had one in the last 12 months

Ultrasound guided aspiration of a seroma of adequate volume is essential to test for this disease.  This is then sent for cytological (microscopic) examination to be able to make the diagnosis of BIA-ALCL and to exclude other causes.

Package price A (Initial consultation + Mammogram* + Ultrasound)

750

Package price B (Initial consultation + Ultrasound)

550

*Women eligible for mammograms:

  • 40 years and older and
  • haven't had their routine mammogram in the last 12 months

If fluid or mass around the implant is found during imaging, this fluid is collected through fine needle aspiration and sent to a pathology lab for testing. The sample is tested for CD30 immune staining (CD30IHC). CD30 is a protein found in higher than normal amounts on lymphoma cells, particularly in BIA-ALCL.

This testing is important to diagnose or rule out BIA-ALCL.

As mentioned previously, the main treatment for BIA-ALCL is surgery. Total capsulectomy and En-bloc capsulectomy are the two forms of surgery performed, both aimed at removing the implant and the capsule i.e. scar tissue completely.

There is no set time frame for when you need a MRI or ultrasound for your breast implants. However, if you develop any symptoms or have concerns you should check in with your consultant and book in an ultrasound through them.

For women who are over 40, you must continue to have your annual breast screening done.

More information can be found at gov.uk

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