With a recent news article about breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL), this rare disease has gotten more notice. Here are the important facts: BIA-ALCL has been recognized since 2011, and to date there have been 359 medical device reports made to the FDA (though these are unconfirmed, and may be duplicates). To give you perspective, around 550,000 breast implants are placed per year. BIA-ALCL is associated with textured breast implants, and the lifetime risk is 1:30,000 women who have these kinds of implants. Most implants are smooth (over 80% of implants), the texture is added for anatomic-shaped implants to help prevent rotation and displacement. The recently popular anatomic cohesive gel implants (“Gummy bear”) are generally textured; only one company, Mentor, has started to offer smooth anatomic cohesive gel implants. When treated appropriately, 93% of patients with BIA-ALCL are disease-free. What to look for: swelling suggesting a fluid collection around the implant, more than one year after implant placement. If you have any concerns, please do see your breast or plastic surgeon. Here is more information from the American Society of Plastic Surgeons.
One of the toughest parts of breast cancer treatment is going through chemotherapy and losing your hair. Vogue magazine has recently profiled women who have adapted to the changes: No Hair, Don’t Care: A Bold New Look Discovering the Beauty of Standing Out in the Crowd Even though I support women adapting to the changes that life brings, I also understand the draw of being able to keep your hair. At UCSF they are in the process of studying the use of a cooling cap, now commonly used in Europe, that keeps hair intact through chemotherapy. Keeping Your Hair in Chemo Hopefully it will be FDA approved and more available here!
Two years ago, Angelina Jolie bravely wrote about her decision to undergo a double mastectomy because of her high risk of breast cancer from carrying the BRCA1 gene. This is an individual choice that each woman has to address with her doctors, based on her personal family history and her wishes. Not everyone can finish the reconstructive process so quickly – it often takes more than 6 months – but showing how she continued to live her life can help other women make their decision to undergo the procedures. Today, she wrote about her choice and experience deciding to go even further to reduce her risk of ovarian cancer, by having her ovaries removed. This results in premature menopause. Again, not everyone with the gene needs to do this, but I think it’s great that she shared the process she went through, so that other women may be encouraged to consider their options.