Studies have identified an association between some types of textured breast implants and a rare form of non-Hodgkin lymphoma called breast implant–associated anaplastic large cell lymphoma (BIA-ALCL). This type of cancer affects the immune system and can develop near the textured implant.
An estimated 145 000 women have breast implants in Québec, all types taken together. Of this number, experts estimate that fewer than 10% have textured breast implants. This type of implant has been used for implant replacement, reconstructive surgery (tumorectomy, mastectomy) or cosmetic surgery.
Women with textured breast implants have an increased but very low risk of developing BIA-ALCL. Indeed, the incidence of BIA-ALCL is very low. According to the American Food and Drug Administration (FDA), the absolute risk for patients who have textured breast implants is estimated to be 1 in 3 817 to 1 in 30 000. BIA-ALCL occurs equally in people with saline-filled breast implants and those with silicone gel–filled breast implants.
In its latest news release issued on May 28, 2019, Health Canada reported that it had been informed of 26 confirmed Canadian cases of BIA-ALCL, 22 (85%) of which involved Allergan’s Biocell breast implants. Based on case data and implant sales data provided by the manufacturers, Health Canada estimates that the risk of BIA-ALCL is 1 in 3 565 for Allergan Biocell macrotextured implants and 1 in 16 703 for Mentor Siltex microtextured implants. No cases of BIA-ALCL have been reported in Canada with smooth surface implants.
The Ministère de la Santé et des Services sociaux (MSSS) would like to reiterate to women who might be concerned about the situation that everything is being done to provide them with the necessary follow-up and support.
The MSSS has taken the initiative to ask public institutions in the health and social services network to review patient records and identify those who received textured breast implants.
As a preventive measure, patients who had breast reconstruction surgery in a public institution have been contacted to inform them of the situation and remind them what unusual symptoms they should be on the lookout for.
On April 4, 2019, Health Canada informed Allergan of its intention to suspend its licences for Biocell breast implants as a precautionary measure in order to protect Canadian patients.
On May 28, 2019, Health Canada officially announced its decision to suspend Allergan’s licences. Allergan is the main supplier of textured breast implants in Canada. More specifically, this announcement included the following:
- A list of Allergan’s Biocell breast implants that may not be sold in or imported into Canada. At Health Canada’s request, Allergan agreed to voluntarily recall unused Biocell breast implants from the Canadian market. Allergan’s other breast implants are not affected by this decision.
- Breast implant removal is not recommended to patients if they do not have any signs or symptoms suggestive of BIA-ALCL. Patients should discuss the risks and benefits of removal with a health professional.
Symptoms to Watch For
BIA-ALCL is characterized by unusual breast changes. If you have textured breast implants, see your doctor (surgeon, oncologist or family doctor) if you notice any of the following signs or symptoms:
- increase in breast size, with or without pain;
- hardening of the breast;
- lump in the breast or armpit;
- skin rash (erythematous rash, change in the colour of the breast).
Imaging tests and tests for your particular situation, such as an ultrasound, biopsy or fluid draw (fine needle biopsy), will be ordered by the doctor.
BIA-ALCL occurs at least 1 year and on average 8 to 10 years after textured breast implant surgery.
BIA-ALCL is not a cancer of the mammary gland (common breast cancer). There is nothing to indicate that breast implants cause cancer of the mammary gland.
If you do not notice any unusual symptoms, there is no need to worry. Indeed, if you do not have any clinical signs or symptoms, Health Canada recommends:
- performing regular breast self-examination and going to see your doctor periodically for follow-up;
- consulting a health professional or Info-Santé 811 if you notice any unusual changes in your breasts.
BIA-ALCL is easy to treat. When diagnosed early, it generally grows slowly and the prognosis is excellent, especially when it is treated with surgery.
To Find out More about Your Record
If you have breast implants but don’t know if they are textured implants or not, you will find this information in your medical record. You can obtain your record from the institution or private clinic where you had the surgery.
If your doctor has passed away or has retired and you had surgery at a private clinic, contact the Collège des médecins du Québec at the following number for more information about the holder of your medical record.
If you would like to know your doctor’s status, you can also consult the Physician Directory on the Collège des médecins du Québec’s website.
Contact Information for Public Institutions by Region
The public institutions concerned have set up telephone lines especially for patients who received textured breast implants at their facilities.
Region 01 - Bas-Saint-Laurent
Region 02 – Saguenay – Lac-Saint-Jean
Centre intégré universitaire de santé et de services sociaux du Saguenay – Lac-Saint-Jean
Region 03 – Capitale-Nationale
CHU de Québec – Université Laval
Region 04 - Mauricie et Centre-du-Québec
Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec
819 697-3333, poste 63349
Region 05 – Estrie
Centre intégré universitaire de santé et de services sociaux de l’Estrie – Centre hospitalier universitaire de Sherbrooke (CHUS)
819 346-1110, poste 22666
Region 06 – Montréal
- Centre intégré universitaire de santé et de services sociaux du Centre-Ouest-de-l’Île-de-Montréal
514 340-8222, poste 26086 (service offered in French)
514 340-8222, poste 26087 (service offered in English)
- Centre intégré universitaire de santé et de services sociaux de l’Ouest-de-l’Île-de-Montréal
To find out more, go to the CIUSSS de l’Ouest-de-l’Île-de-Montréal website
- Centre intégré universitaire de santé et de services sociaux du Nord-de-l’Île-de-Montréal
514 338-2222, poste 2983
To find out more, go to the CIUSSS du Nord-de-l’Île-de-Montréal website
- Centre intégré universitaire de santé et de services sociaux de l’Est-de-l’Île-de-Montréal
514 252-3400, poste 7141
To find out more, go to the CIUSSS de l'Est-de-l’Île-de-Montréal website
- Centre universitaire de santé McGill (CUSM)
514 934-1934, poste 35953
- Centre hospitalier universitaire Sainte-Justine
- Centre hospitalier de l'Université de Montréal (CHUM)
1 833 802-5152 (toll-free number)
Region 07 – Outaouais
Centre intégré de santé et de services sociaux de l’Outaouais
819 966-6200, poste 335978
Region 08 – Abitibi-Témiscamingue
Centre intégré de santé et de services sociaux de l’Abitibi-Témiscamingue
819 732-0760 (number of the doctor in charge)
Region 09 – Côte-Nord
Centre intégré de santé et de services sociaux de la Côte-Nord
Contact the hospital where you had the surgery.
Region 11 – Gaspésie–Îles-de-la-Madeleine
Centre intégré de santé et de services sociaux des Îles
418 986-2121, poste 8349 (number of the responsible person)
Region 12 – Chaudière-Appalaches
Centre intégré de santé et de services sociaux de Chaudière-Appalaches
Region 13 – Laval
Centre intégré de santé et de services sociaux de Laval
1 844 975-5397 (toll-free number)
Region 14 - Lanaudière
Region 15 - Laurentides
Centre intégré de santé et de services sociaux des Laurentides
1 833 627-6477
Region 16 - Montérégie
- Centre intégré de santé et de services sociaux de la Montérégie-Est
To find out more, go to the CISSS de la Montérégie-Est website
- Centre intégré de santé et de services sociaux de la Montérégie-Centre
1 888 359-6556, poste 3636 (toll-free number)
- Centre intégré de santé et de services sociaux de la Montérégie-Ouest
450 699-2425, poste 2657
Last update: June 6, 2019