Anaplastic large cell lymphoma (ALCL) is a rare disease whose incidence has recently increased; this increase may be related to the growing popularity of textured breast implants. Some breast cancer patients who have a mastectomy may wonder if the advantages of receiving reconstructive implants outweigh the possibility of having a second cancer in light of this trend.
The study was published in the journal JAMA Network Open.
A new Columbia study should make many women’s decisions easier. The study found that the risk of developing ALCL after reconstructive surgery is extremely low: each year, about 12 cases are expected to occur in 1 million women who have had reconstructive surgery.
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“The risk of developing ALCL is actually much lower than the risk of experiencing a breast cancer recurrence,” says lead author Connor J. Kinslow, MD, a radiation oncology resident at Columbia University Vagelos College of Physicians and Surgeons. .
“Based on our findings, we do not believe that women should be discouraged from implant-based breast reconstruction after mastectomy solely because of the risk of ALCL.”
The new study was designed to give women accurate risk information and is the first to look at rates of ALCL in breast cancer survivors who had breast implants after mastectomy.
Researchers used a national cancer registry to identify 57,000 women who underwent mastectomy with implant reconstruction for breast cancer or ductal carcinoma in situ (an early, noninvasive stage of breast cancer) between 2000 and 2018. The average duration of follow up was seven years. , and about 16,000 women were followed for at least 10 years.
Although the study found that women who have had breast implants post-mastectomy have a higher risk of ALCL than women in general (each year, 0.3 cases per million are expected in the general population), “it should be noted that ALCL is a rare cancer,” said study leader David Horowitz, MD, assistant professor of radiation oncology at Columbia University Vagelos College of Physicians and Surgeons. “Of the 57,000 women in the study, only five cases of ALCL were diagnosed in the 421,000 years of combined follow-up.”
“Women who have had one cancer are understandably nervous about having a second one,” Kinslow said. “But that shouldn’t necessarily put them off having reconstructive implants. For many women, breast reconstruction after mastectomy is extremely important to quality of life, and women should feel comfortable continuing with implants without the added psychological burdens that come with a breast cancer diagnosis.”
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