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.

Preventive Action

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.

Collège des médecins du Québec
514 933-4441
1 888 MÉDECIN (633-3246) (toll free number)

If you would like to know your doctor’s status, you can also consult the Physician Directory This hyperlink will open in a new window. 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

Centre intégré de santé et de services sociaux du Bas-Saint-Laurent
418 724-3000, poste 8248
1 888 998-7901 (toll-free number)

Region 02 – Saguenay – Lac-Saint-Jean

Centre intégré universitaire de santé et de services sociaux du Saguenay – Lac-Saint-Jean
418 541-1089

Region 03 – Capitale-Nationale

CHU de Québec – Université Laval
418 682-8001

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

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
418 835-1308

Region 13 – Laval

Centre intégré de santé et de services sociaux de Laval
450 668-1010, poste 55330 (clinique de plastie)

Region 14 - Lanaudière

Centre intégré de santé et de services sociaux de Lanaudière

Region 15 - Laurentides

Centre intégré de santé et de services sociaux des Laurentides
1 833 627-6477

Region 16 - Montérégie