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Breast implants linked to rare immune system cancer: HSA

Breast implants linked to rare immune system cancer: HSA

A technician displays a silicone breast implant. (File photo: AFP/Miguel Medina)

SINGAPORE: People with breast implants who experience pain or swelling in the area are encouraged to consult their doctors as some implants have been linked to a rare form of cancer, the Health Sciences Authority (HSA) said on Friday (May 10).

The advisory came as more information has recently come to light on the risk of developing Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), HSA said.

The rare type of lymphoma, that usually develops around breast implants, is a cancer of the immune system and not a type of breast cancer. It has been reported as early as a year, or as late as 37 years, after breast implant surgery, said HSA.

To date, HSA has received one report of BIA-ALCL in Singapore. The patient, who was diagnosed early, is said to be recovering.

Those who experience pain or swelling around their implants after the surgical incision has healed should seek medical attention. If diagnosed early, the condition can be successfully treated with surgery, said HSA.

In cases where the cancer has spread to other parts of the body, further treatment such as radiation or chemotherapy and targeted immunotherapy have been used.

Those with breast implants are advised to conduct regular breast self-examination and continue with the periodic follow-up post-implantation, as scheduled by their doctor.

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 for patients who experience no symptoms of swelling, lumps or pain around the area.

“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 HSA’s expert panel member on breast implants.


In February, HSA convened an expert panel to assess the evolving situation and risk of BIA-ALCL as well as relevant mitigation measures.

Based on current scientific data, the panel assessed that textured surface implants appear to be associated with a higher risk than the smooth ones. However, the risk factors associated with the disease are still unclear.

HSA has taken the precautionary measure of disallowing the sale of Allergan Natrelle breast implants, a type of macro-textured breast implant, in Singapore since April.

READ: Allergan stops sale of textured breast implants in Europe

Globally, the majority of persons with breast implants who have developed BIA-ALCL have had textured implants.

Macro-textured breast implants are associated with the highest risk of BIA-ALCL, and the Allergan Natrelle breast implant is the only macro-textured breast implant registered in Singapore.

“The estimated incidence rates of BIA-ALCL reported in literature range from one in 3,817 to one in 30,000 persons with textured breast implants. Further review of the global reports on BIA-ALCL indicates a relatively higher incidence rate in those implanted with macro-textured breast implants,” HSA said in a statement.

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

HSA had also informed relevant healthcare professionals in October 2017 to highlight the risk of BIA-ALCL and the possible link to textured surface breast implants to patients, and to report any cases they encounter to HSA.

HSA added that there are also a few unconfirmed reports of BIA-ALCL in patients who have received smooth-surfaced implants. The possible association is currently being investigated by regulators globally.


It is estimated that about 10 million to 35 million breast implants have been implanted worldwide. There have also been about 800 reports, both confirmed and unconfirmed, of BIA-ALCL.

Those who opt for breast implants typically do so for reconstruction or augmentation purposes. 

The panel noted that BIA-ALCL occurrences are rare and the associated mortality rates remain low.

HSA added that it will continue to closely monitor global developments and review the evolving scientific information regarding this safety issue, as well as update the public with more information should there be any significant new findings.

Source: CNA/zl(hm)


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