Breast Implant Surgery After Mastectomy May Raise Risk of Other Lymphomas
New research suggests links beyond the known risk of ALCL, though overall risk remains low
Topline
A large U.S. population study found that post-mastectomy breast implant reconstruction is linked not only to the rare anaplastic large-cell lymphoma (ALCL) but also to other types of non-Hodgkin lymphomas (NHLs) of the breast. While the absolute risk remains extremely low, researchers recommend that patients be informed of these risks during surgical decision-making.
Study Details
The study analyzed data from 61,043 women who underwent implant-based reconstruction following mastectomy between 2000 and 2020, using the SEER 17 cancer registry. Median age at surgery was 51, and median follow-up was 86 months. The goal was to assess whether other lymphoma subtypes beyond ALCL might also be associated with breast implants.
Methodology
Researchers calculated standardized incidence ratios (SIRs) for breast lymphomas in women with post-mastectomy implants and compared them to population-level rates. They looked specifically at cases of non-Hodgkin lymphoma occurring in the breast, excluding Hodgkin lymphoma and systemic disease outside the breast.
Key Findings
Total cases: 15 NHLs of the breast identified.
ALCL: 7 cases (SIR 41.6).
Other NHL subtypes: 8 cases (SIR 2.84).
5 diffuse large B-cell lymphomas (SIR 5.26)
2 small lymphocytic lymphomas (SIR 16.7)
1 peripheral T-cell lymphoma, NOS (SIR 11.8)
Median time from implant surgery to lymphoma diagnosis: ~83 months.
Absolute excess risk:
ALCL: 14.3 per 1,000,000 persons/year
Other NHL: 10.8 per 1,000,000 persons/year
No increased risk seen for Hodgkin lymphoma of the breast, NHL outside the breast, or in women who had mastectomy without implants or lumpectomy.
Implications for Practice
Implications for Patients
Breast implant-associated lymphomas remain very rare.
Risks extend beyond ALCL, but numbers are still small.
Patients should discuss reconstruction choices in the context of personal risk tolerance and long-term monitoring.
Implications for Providers
Include both ALCL and other NHL risks in pre-surgery counseling.
Follow FDA guidelines, including the black box warning and 2022 safety alert on rare cancers in implant capsules.
Monitor for late-onset breast swelling, lumps, or skin changes.