What to know about breast implants By Dr Tim Cooper, Plastic Surgeon, Nedlands Women with breast implants are increasingly concerned about the risk of developing cancer or implant-related illness. They may be experiencing breast pain or other unexplained symptoms and access information online and in the media.
contracture and are positionally more secure. The TGA and the FDA have withdrawn macro-textured implants from the market. Allergan, one of the implants most commonly involved with ALCL, voluntarily withdrew its product. The TGA has mandated implant manufacturers report any episodes of ALCL but has not recommended that all textured implants be removed in the absence of ALCL diagnosis. Gathering information regarding breast implants has been advanced by the ABDR (Australian Breast Device Registry) for all implantrelated surgery.
There is considerable confusion as to the difference between BIA ALCL (Breast implant associated anaplastic large cell lymphoma), breast cancer, and BII (breast implant related illness). Many women with implants may well be concerned about a silent rupture. BIA ALCL is a rare form of nonHodgkin’s Lymphoma, first classified as a distinct clinical entity by the WHO in 2016. It typically presents as an unexplained swelling of one or both breasts 5-10 years post implantation. ALCL has never been reported in smooth implants and appears related to more textured implants. The more coarse, or macrotextured, implants have an incidence as high as one in 2000 breast augmentations, whereas the micro-textured products (all listed on TGA implant hub) have an
ALCL is diagnosed by cell cytology and immunohistochemistry of seroma fluid from US-guided aspiration. incidence of 1 in 80,000. This needs to be put in the context of the high lifetime risk of developing breast cancer. Tissue expanders and anatomically shaped implants only come as textured products. Textured implants are often preferred as they have a lower risk of capsular
Evidence supports the development of a low-grade infection with the formation of a bacterial biofilm attached to the textured surface of the implant in someone who is immunologically compromised. Recommendations have been made to minimise bacterial contamination in implant surgery.
Beechboro Family Practice High patient volume at busy centre • Full time/part time position available • Large and modern practice • Collegial environment
• Excellent CDM and treatment room nurse support • This position would ideally suit a female GP
To learn more, contact Sandy McNab on 0419 917 010 or sandy.mcnab@ipn.com.au for a confidential discussion 44 | FEBRUARY 2020
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