Current research hasn’t found a connection between breast cancer and breast implants. But textured implants may increase your risk for a type of non-Hodgkin’s lymphoma called anaplastic large cell lymphoma (ALCL).

Some breast implants slightly raise the risk of an uncommon type of lymphoma. But implants don’t increase the risk of developing breast cancer.

The U.S. Food and Drug Administration (FDA) first noted a possible link between breast implants and cancer in 2011. It’s not breast cancer, which forms in cells on the breast, but an immune system cancer called anaplastic large cell lymphoma (ALCL).

ALCL is a type of non-Hodgkin’s lymphoma. It’s rare and estimated to account for only 1% of non-Hodgkin’s lymphoma cases and 16% of T cell lymphomas. Worldwide, it’s caused 1,264 cases and 63 deaths as of 2023.

Breast implant-associated ALCL (BIA-ALCL) develops in scar tissue and fluid near the implant. Like any cancer, it can spread. Without treatment, it can cause death.

A 2021 systematic review cites studies that found an association between breast implants and increased risk of BIA-ALCL. However, the risk can depend on the implant manufacturer and whether the implant is textured.

Study authors estimate the risk of BIA-ALCL to fall between 1:355 and 1:51,000 in people with a textured surface breast implant in the United States.

In 2019, the FDA alerted healthcare providers about a link between all breast implants, regardless of filling or texture, and BIA-ALCL. The agency informed doctors of 573 cases of BIA-ALCL worldwide, with 33 deaths. Of the 573 cases, 481 people had Allergan breast implants at diagnosis.

Allergan voluntarily recalled its Biocell saline and silicone-filled textured breast implants and tissue expanders in July 2019.

Symptoms of systemic ALCL may include:

Cutaneous ALCL mainly affects the skin. Symptoms can include skin lesions that don’t heal.

Other signs and symptoms of BIA-ALCL can include:

  • persistent swelling of the breast
  • a lump or mass near the implant
  • asymmetry of the breasts
  • tenderness or pain near the implant

Symptoms can start any time after your breast implant surgery but often take years to develop.

If your doctor suspects BIA-ALCL, the next step will likely be an ultrasound or MRI.

If there is excess fluid around the implant, a sample can be obtained with fine needle aspiration. If there is a mass, a tissue biopsy is needed. These samples will be sent to a laboratory for testing.

There’s no evidence that breast implants raise the risk of developing any other types of cancer, including breast cancer.

There is a question about breast cancer recurrence.

A 2020 study assessed breast cancer outcomes according to the types of implants used for reconstruction following mastectomy. Findings suggest there may be a link between textured implants and a higher risk of breast cancer relapse. The researchers said more studies are needed, though.

Other considerations

Scar tissue can change the shape and feel of implants, so they may no longer look or feel quite right.

Infection or rupture of the implants can also cause these changes. That’s why many people eventually have another surgery to remove or replace them.

Although changes around breast implants are not uncommon, they’re rarely due to cancer. When you have symptoms, it’s important to see a doctor to find out for sure.

Research from 2020 suggests that textured surface implants are associated with higher risk than smooth surface implants. Textured tissue expanders may also be of concern.

The FDA estimated the risk of BIA-ALCL with Allergan Biocell textured implants to be 6 times that of other types of textured implants.

The reason textured implants are associated with BIA-ALCL isn’t clear. The rough surface could cause inflammation, or genetic factors could also be involved.

There doesn’t appear to be a difference in silicone versus saline for BIA-ALCL risk. But this hasn’t been thoroughly evaluated in large studies.

Allergan recalled its Biocell textured breast implants in 2019, but you may have had yours implanted prior to the recall. Even so, the FDA does not recommend removing implants if you don’t have symptoms.

The longer you have the implants, the more likely complications become. Still, the risk of BIA-ALCL is low.

If you have textured breast implants, or you don’t know what kind you have, it’s worth having a discussion with your doctor. Regardless, you need regular check-ups to catch any problems early.

Warning signs of BIA-ALCL include

  • persistent swelling due to a buildup of fluid
  • a lump or mass in or around the breast or under the arm
  • breast tenderness or pain
  • tightness, firmness in the breast
  • changes to the shape or size of the breast

See a doctor right away if you have these or other changes near your implants.

Treatment for BIA-ALCL usually involves surgical removal of the implant and surrounding scar tissue. You may need additional treatments — such as chemotherapy and radiation therapy — if the cancer has spread.

The FDA has warned that textured implants may slightly increase your risk of developing ALCL, a type of lymphoma. The type of implants associated with this cancer were recalled in mid-2019.

If you still have these implants but are symptom-free, it may not be necessary to remove them. Symptoms or not, you should see a doctor regularly to have them checked.

When it comes to keeping this type of implant or having them removed, there’s no one-size-fits-all answer. Talk with your doctor about the risks and benefits of breast implants and surgery to remove them.