SINGAPORE – Textured breast implants have been found to be linked to a rare form of cancer of the immune system called anaplastic large-cell lymphoma, the Health Sciences Authority (HSA) said on Friday (May 10).

Breast implants have a silicone outer surface that is either smooth or textured.

Globally, most people with breast implants who developed the lymphoma have had textured implants.

The cancer, which the HSA refers to as breast implant associated-anaplastic large cell Lymphoma (BIA-ALCL), usually involves a swelling around the implant.

It has been reported to have occurred as early as one year and as late as 37 years after the breast implant surgery.

The HSA said it has “taken the precautionary measure of disallowing the sale of the Allergan Natrelle breast implant”.

It is the only macro-textured breast implant – which is associated with the highest risk of BIA-ALCL – registered here and the ban came into force last month.

There are seven other registered brands of breast implants in Singapore.

In February, an expert panel comprising healthcare professionals from public and private hospitals was also convened to “assess the evolving situation and risk of BIA-ALCL, as well as relevant mitigation measures”.

The panel concluded that “textured surface implants appeared to be associated with a higher risk than the smooth ones”, though the risk factors associated with the disease are unclear. It also noted that BIA-ALCL occurrences are rare and the associated mortality rates remain low.

Professor Ong Yee Siang, head and senior consultant of plastic, reconstructive and aesthetic surgery at the Singapore General Hospital, said the removal of breast implants is not necessary if patients do not exhibit symptoms of swelling, lumps or pain around the implant.

“Consult your doctor to discuss your options if you are concerned. In addition, patients considering breast implants should discuss the risks and benefits of the different types of implants with your doctor,” said Prof Ong, who is also a member of the HSA’s expert panel.

To date, the HSA has received one report of BIA-ALCL locally. It said: “The patient, who was diagnosed early, is recovering.”

Since 2017, following emerging scientific reports, manufacturers of breast implants have been required to include cautionary statements regarding the risk of BIA-ALCL in the package inserts of breast implants registered in Singapore.

Healthcare professionals were also asked to highlight the risk of BIA-ALCL and the possible association with textured surface breast implants to patients, and to report any BIA-ALCL cases they encounter to the HSA.

Worldwide, there have been an estimated 10 million to 35 million breast implants with approximately 800 reports of patients developing BIA-ALCL.

If diagnosed early, the cancer can be successfully treated with surgery. However, in cases where it has spread to other parts of the body, further treatment such as radiation or chemotherapy and targeted immunotherapy may be used.

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