The conclusions were based on an analysis of data from a registry of all patients in the Netherlands who were diagnosed with Anaplastic Large Cell Lymphoma (ALCL) of the breast between 1990 and 2016.
ALCL is a rare type of breast cancer in the fluid surrounding a breast implant. It occurs when inflammation-fighting cells grow uncontrollably, but the mutated cells do not work very well and crowd out health cells.
The researchers identified 43 patients with ALCL of the breast, including 32 with breast implants — and 82% had textured implants, though textured implants were far less common than smooth implants.
ALCL is very rare, even among women with breast implants. The researchers estimated that 82 women per 1 million with breast implants would develop ALCL by the time they were 70 years old.
In comparison, only 0.35 women per 1 million in the general population will develop ALCL of the breast. The researchers concluded that this all but confirms that breast implants cause ALCL:
We now confirm that implants strongly increase the risk of this rare type of lymphoma. Our relative risk estimate of over 400, implying an attributable risk approaching 100%, is highly suggestive of a direct or indirect causal role of the breast implant in breast implant-associated ALCL.”
Other studies have concluded that textured implants become contaminated with bacteria during the implant procedure, but the immune system has a harder time killing off the bacteria.
This is because bacteria forms a “biofilm” on the textured surface, unlike a smooth implant. Experts believe this can result in chronic low-level infection that increases the risk of lymphoma over many years.