BIA-ALCL breast implant associated cancer update – August 2017

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is a very rare cancer that can be effectively treated, when detected early. Recent media reports may have caused confusion amongst women who have - or are considering getting - breast implants for augmentation or reconstruction. This post seeks to clarify what we know about BIA-ALCL. Last year 1.5 million implants were inserted worldwide. The number of people having breast implant surgery in Australia has risen by more than 1,000% since 2005, from approximately 4,000 per year - to over 40,000. More people have implants now than ever before, and so we would expect the number of people reporting complications now to be proportionally higher than what they were 5, 10 or 20 years ago. The TGA has been posting updated information about BIA-ALCL since 2011. As of August 2017, we haven’t seen one case of BIA-ALCL in our clinic, nor amongst our patients. What is BIA-ALCL? It is a cancer of lymphatic cells; a form of Non-Hodgkin’s Lymphoma (not breast cancer). What causes BIA-ALCL? Media focus has concentrated predominantly on implants, but there’s actually 4 unifying factors that contribute to an increased risk of BIA-ALCL: • Textured implants with a high surface area texture • Bacterial contamination at the time of surgery • Patient genetic predisposition • Time for the process to develop How long does BIA-ALCL take to develop? An average of 7-10 years after implant insertion. But women who have breast implants should regularly check their breasts for changes at any stage after breast augmentation surgery - most of all for actual breast cancer, which occurs in 1 in 8 women,...

What is a dermal matrix and how is it being used in breast surgery?

What is an allograft? Allograft is an organ or tissue donated from one individual to another. What is an acellular dermal matrix? It is an allograft made from donated human dermis (skin). An acellular dermal matrix (ADM) is a soft tissue substitute that can replace or support tissues; in plastic surgery they are increasingly being used for breast implant revision and breast reconstruction surgery. Derived from donated human skin, it looks like a thin layer of white leather. The matrix undergoes a number of processes to remove the epidermis, sterilise the matrix and reduce the likelihood of a rejection response. How does Dr Sharp use ADM? Dr Sharp uses the latest generation of ADM, developed specifically for restorative breast surgery. It provides lower-pole support for women having an implant placed in their breast that may require additional tissue to support the lower portion of the implant - for example, in breast reconstructions or breast implant revision surgery. The mesh is attached to the pectoralis muscle in the chest – increasing the size of the pocket in which the implant is placed - acting as a hammock, cradling the breast implant and helping to create a more natural breast contour. The use of an acellular dermal matrix offers a number of advantages as it provides structural support for the breast, acts as tissue matrix for the body’s own tissue ingrowth, produces consistent results and is available in multiple sizes to meet the needs of each patient’s surgery. How is ADM used in breast implant surgery? ADM can be used as a support ‘sling’ for the breast implant, where natural tissue is lacking or deficient. This is increasingly...

What is a preventative mastectomy?

Angelina Jolie brought preventative mastectomy surgery into the public spotlight in 2013 when she underwent the procedure following genetic profile testing, which confirmed that she was carrying the BRAC-1 gene mutation. Her mother’s death due to breast cancer prompted her to have the testing - and subsequent surgery to remove her breasts in an aim to prevent the disease from forming in her body. Jolie opted to have a breast reconstruction to replace the lost breast tissue. The BRAC-1 gene mutation is linked to the development of breast cancer in women and men, and many are now choosing to have both breasts removed, in what is described as a bilateral preventative mastectomy. This is a deeply personal decision and one that is made after testing, counselling and consideration. You may consider having a preventative mastectomy if you have a strong family history of breast cancer and/or if genetic testing suggests a strong likelihood that you may be diagnosed with breast cancer in future. Preventative mastectomy is a big decision. It involves much consideration, consultation with healthcare professionals and genetic counselling. Preventative mastectomies remain a contentious issue amongst many medical professionals, as there is concern over health breasts – that may never develop cancer – being removed ‘just in case’, particularly at a young age. The overwhelming feedback from women who have chosen to undergo a preventative mastectomy is that what they have lost in breast form or function, they have gained through relief from the anxiety and constant fear of developing the cancer that has often robbed them of a close family member. FREQUENTLY ASKED QUESTIONS ABOUT PREVENTATIVE MASTECTOMY SURGERY + RECONSTRUCTION Are there...

More than skin deep: the health benefits of plastic surgery

People seek out plastic surgery for myriad reasons. For some, it’s the correction of a trauma, accident or genetic deformity - for others, it’s reconstructive surgery for skin or breast cancer; replacing what previous surgery has taken away. Others want to restore what time has take away; growing old gracefully - and retaining a ‘natural look’ while ensuring they look as good as they still feel on the inside. The health benefits of plastic surgery often go unmentioned in the world of glossy magazines that focus purely on cosmetic improvement, looking beyond the ‘skin deep’ image to see significant functional benefits, including: Rhinoplasty: can improve breathing and snoring Blepharoplasty: can improve vision Breast reduction and tummy tuck (abdominoplasty): can improve back and neck pain Non surgical treatments such as cosmetic wrinkle injections can also have little-known medical benefits, such as reducing headaches and treating excessive sweating (hyperhidrosis). Plastic surgery alone will not improve your confidence or self esteem; but it can be one of many decisions people make to improve their self image and align the face (or body) they see in the mirror with how they feel on the outside. Elevated self esteem is associated with improved self confidence, which can have a powerful influence over relationships, job prospects and social networks; something noted by London economics Professor Daniel Hamermesh in his research into the link between appearance and employment. Although plastic surgery is often thought of as nip-and-tuck procedures that are purely driven by aesthetics, it can also be a powerful tool to resolve functional problems and improve overall health and wellbeing. It’s important to select a surgeon...

Know your body: do you know the 5 signs of breast cancer?

The chance of a woman developing breast cancer up to age 85 is 1 in 8. One woman dies from breast cancer every 16 hours in Queensland. While those figures sound depressing, when breast cancer is detected early, women have a much greater chance of being treated successfully. And for most women, the cancer will not return after treatment. Breast cancer will affect all of us at some time in our lives; whether it be a loved one, colleague, friend – or ourselves – diagnosed with this common form of cancer. Breast cancer is often thought of as a woman’s disease, but it also occurs in male glandular chest tissues as well. Knowing the signs is key to early detection. A defined lump is not always the first sign of breast cancer. Breast cancer symptoms can include: Thickening of the breast tissue Nipple discharge Redness or scaling of the nipple A nipple that becomes inverted (turned inwards) Unexplained redness, swelling, skin irritation, itchniness or rash on the breast. Women of all ages should be familiar with the normal look and feel of their breasts. If you notice any of the following changes please see your doctor immediately: A lump, lumpiness or thickening of the breast Changes in the skin of a breast, such as puckering,dimpling or a rash Persistent or unusual breast pain A change in the shape or size of a breast Discharge from a nipple, a nipple rash or a change in its shape The signs of breast cancer can involve all of these – or none at all. It’s important to remember that the best defence...

New study focuses on breast density link to cancer

The University of Western Australia (UWA) is calling for participants to join a pilot study into breast density among young women, in the hope of understanding cancer risks later in life. High breast density is a strong predictors of breast cancer in older women, giving them a four to six times greater likelihood of developing cancer than women with low density. Hoping to identify factors associated with increased density in younger populations, UWA is seeking women aged between 18 and 40 to participate in the study. If you live in West Australia and are interested in participating, click here to find out more. Participants will be measured using a Transillumination Breast Spectroscopy, or TiBS using visible and near-infrared light. Researchers hope the machine may be used for screening under-40’s in the future, to monitor change in those typically too young to have mammograms. Breast density can be impacted by smoking, alcohol and contraceptive use, giving an insight into future prevention strategies. Dense breasts are common and despite being a risk factor for cancer, they alone are not an indication that a woman will develop the disease. The study will be funded by the National Breast Cancer Foundation. % breasts are classified as 'dense' when more than 50% of a breast consists of fibroglandular tissue % of women do not know if they have dense breasts % up to 40% of breast cancer goes undetected by mammography alone in women with dense breasts...