The major Plastic Surgery Association just came out with a statement about the new headlines “Breast Implants Associated with new cancers.” 
Yes, this is true. On September 8, 2022 the FDA released a new safety communication about squamous cell cancer and various lymphomas which were found in the capsule around breast implants. The document is available to anyone on the FDA’s Medical Device Safety webpage.
There are 16 reported cases in the literature, and 2 unverified other reports.
“BIA-SCC is a very rare but potentially aggressive epithelial-based tumor that appears to be associated with breast implants and emanates from the breast implant capsule. At this time, ASPS/PSF is aware of so few reported cases of BIA-SCC that it is not possible to determine what factors increase patient risk.
Breast implant-associated squamous cell carcinoma (BIA-SCC) is a very rare but potentially aggressive, epithelial-based tumor that appears to emanate from the breast implant capsule. Pathology shows sheets of squamous cells lining the capsule in nests and bundles. BIA-SCC can exhibit highly invasive properties including spread to lymph nodes, local tissues and distant sites, such as muscle and bone.
BIA-SCC is not a cancer of the breast tissue itself.”
ASPS/PSF is committed to driving patient safety and informed decision making through research and the ongoing and persistent surveillance of breast implants. Information for your patients may be found on the ASPS webpage (Breast Implant Safety: What Patients Need to Know).
What we know:
- Number of reported patients currently: 18 (Number of breast augmentations done yearly: about 320,000)
- Average length since initial implantation 22.74 years (range 11-40 years)
- Seen in smooth and textured implants
- In saline and silicone breast implants
- In aesthetic as well as reconstructive patients.
- Presentation: Delayed seroma, unilateral swelling, pain, redness, often capsular contracture
- 80% have extracapsular spread
- Imaging: Ultrasound to evaluate for peri-prosthetic fluid +/- aspiration; MRI with and without contrast to evaluate capsule to rule out mass; PET-CT for extent of disease, if present.
- Treatment: En bloc capsulectomy and implant removal. Very important to remove all of the capsule.
My thoughts?
This is SUPER rare. Remember over 300,000 women get implants yearly, and the number of this cancer is 18 patients. Total. It tends to present 20 years out, and it would be interesting to see if those patients had chronic biofilm/capsular contracture/inflammation? Did they have breast cancer and radiation? I know that acne patients in the old days were treated with low dose radiation for their acne. Fast forward 20 years, tons of them had squamous skin cancers.
But this cancer does appear to be more aggressive than ALCL, and can be found in patients with textured or smooth implants, silicone or saline.
I am NOT minimizing the risk, and this should be included in the risk discussion for every woman before breast implant augmentation. But the media – NYT, CNN, Yahoo NEWS, you name it- has taken the headline and ran with it making it sound like hordes of women are now getting cancer. For those who don’t read deeper into the article, the headline is deceptive.