{"entity":{"id":"bia-alcl","kind":"term","name":"Breast implant-associated anaplastic large cell lymphoma","aka":["BIA-ALCL","breast implant-associated lymphoma","implant-associated ALCL"],"tldr":"A rare lymphoma that grows in the scar capsule around a breast implant, usually years later, and usually shows itself as sudden swelling of the reconstructed breast from fluid around the implant. It is strongly linked to textured implants, and it is almost always curable by removing the implant and the whole capsule.","summary":"The best population estimate comes from the Dutch pathology registry, which identified every primary breast lymphoma between 1990 and 2016. Among 43 patients with breast anaplastic large cell lymphoma, 32 had an implant on the same side, against one of 146 women with other primary breast lymphomas, an odds ratio of 421.8 (95 percent confidence interval 52.6 to 3385.2). The absolute risk is small: the cumulative risk in women with implants was 29 per million at age 50 and 82 per million at 70, and 6,920 women would need an implant to cause one case before the age of 75.\n\nThe implant surface matters. In the Dutch series, 23 of the 28 implants of known type in the lymphoma cases were macrotextured, 82 percent, against 45 percent of implants sold in the same country over 2010 to 2015 (p<0.001). A later meta-analysis across 525,475 patients with implants and 254 cases put the median time from implant to diagnosis at 13.16 years (11.7 to 14.6), found cases almost exclusively with textured implants, and found the same risk whether the implant was placed for reconstruction or for cosmetic reasons. One single-institution series of 3,310 patients exposed only transiently to a textured tissue expander, averaging 6.7 months, followed for a mean 6.8 years, found no cases.\n\nWhat it means in practice. Any late seroma around an implant, typically more than a year after surgery, should be aspirated and the fluid sent for cytology and CD30 immunohistochemistry rather than simply drained. Disease confined to the capsule and treated by complete capsulectomy with implant removal has an excellent outcome; disease that has formed a mass or spread needs systemic treatment. Prevention currently rests on avoiding the exposure, on standardised risk communication and on symptom-driven evaluation rather than on removing implants from women who have no symptoms.","asOf":"2026-09-25","links":[{"label":"Breast implants and the risk of anaplastic large-cell lymphoma (JAMA Oncology 2018)","url":"https://doi.org/10.1001/jamaoncol.2017.4510"},{"label":"Risk of BIA-ALCL, systematic review and meta-analysis (Aesthetic Plastic Surgery 2024)","url":"https://doi.org/10.1007/s00266-024-03956-9"},{"label":"Genetic susceptibility and current prevention guidance in BIA-ALCL (Biomedicines 2026)","url":"https://doi.org/10.3390/biomedicines14030600"},{"label":"No cases after transient exposure to a textured tissue expander, 3,310 patients (Plastic and Reconstructive Surgery 2023)","url":"https://doi.org/10.1097/PRS.0000000000010195"}],"tags":[],"related":["breast-reconstruction","mastectomy"],"cancers":["breast-cancer","breast-hr-positive","breast-her2-positive","tnbc","male-breast-cancer"],"sections":["surgery"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["ibra-study"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Side effects"},"route":"/terms/bia-alcl/","neighbours":{"term":[{"id":"breast-reconstruction","kind":"term","name":"Breast reconstruction","route":"/terms/breast-reconstruction/"},{"id":"mastectomy","kind":"term","name":"Mastectomy","route":"/terms/mastectomy/"}],"cancer":[{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"male-breast-cancer","kind":"cancer","name":"Male breast cancer","route":"/cancers/male-breast-cancer/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"section":[{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"trial":[{"id":"ibra-study","kind":"trial","name":"iBRA (implant Breast Reconstruction evAluation)","route":"/trials/ibra-study/"}]}}