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Anaplastic Large Cell Lymphoma (ALCL) is a rare cancer, but its incidence is higher in women with breast implants. The link was confirmed by the European Commission’s Scientific Committee on Health, Environmental and Emerging Risks (Scheer) after the Italian Ministry of Health reported on its website that there was no scientific evidence of the possible correlation between this cancer and breast implants.

Several months ago, with the publication of its Final Opinion on the safety of breast implants in re-lation to anaplastic large cell lympoma, the Committee concluded that the link is more than proba-ble. That is why the Scheer asked the Italian Ministry of Health to correct the wrong information reported on its website. The news made headlines in Italy, where media reported the voice of ex-perts highlighting that the link between breast implants and ALCL is real.

Should women give up the desire of breast remodelling or augmentation? Actually, they have an-other valuable and safe option linked to undeniable advantages: expanded stem cells transplanta-tion. These cells can be obtained from a patient’s excess fat and multiplied in the lab to be injected in the breast to obtain the desired result (both remodelling or augmentation).

Breast implant-associated anaplastic large cell lymphoma

As stated, anaplastic large cell lymphoma is a rare cancer. It is a T-cell lymphoma, and can occur at any age; however, this cancer is more common in children and young adults. Interestingly, men are more affected than women, but the risk of developing a particular form of this cancer is higher in women – particularly in those with breast implants.

In fact, as the Scheer explained in its Final Opinion, a lymphoma can develop near a breast implant. In such a case, the cancer is referred to as Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). It can take more than 20 years to develop, its diagnosis is based on the analysis of the fluid accumulated near the implant or on a biopsy, and the standard of care treatment is surgical resection. More advanced BIA-ALCL can require other treatments too, such as chemo-therapy, radiation therapy or stem cell transplantation.

BIA-ALCL is mainly associated with textured implants, which are the most common breast im-plants in Europe. Being a rare cancer, the entity of BIA-ALCL risk is difficult to establish. Moreo-ver, the mechanisms underlying its development still remain unclear. The involvement of inflamma-tion seems to be sure; however, it is still unknown if this inflammation is generated by the implant’s surface attrition, material released by the implant, or bacterial contamination. Some implant’s com-ponents might promote adverse reactions, and the existence of a genetic predisposition was hypoth-esized too.

The evidence of the link between breast implants and ALCL

To analyse the link between breast implants and ALCL, the Scheer reviewed the scientific literature, including all the papers published between September 1st, 2016 and April 30th, 2020 and all relevant sources published beyond this period. A total of 605 papers were included in the analysis. The evidence of a link between textured implants and anaplastic large cell lymphoma was ranked as “moderate”. Based on the Scheer ranking, which consists of 5 levels, with the 5th level corresponding to “strong”, “moderate” is the 4th level, that is the second stronger level of evidence.

In an interview to the Italian newspaper “La Repubblica”, Fabio Santanelli di Pompeo, Plastic Surgery Professor at “La Sapienza” University in Rome, explained that the link between textures im-plants and ALCL is “pretty sure”: in 2017, the calculated risk for women with breast implants was 67 times higher than in the general population; it increased in 2020; and it is higher in women with textured implants. He added that it is almost impossible to reach a level of evidence greater than “moderate” for cancers that are known since a short time, as BIA-ALCL is. A risk with such a level of evidence should be taken in serious consideration by both clinicians and patients.

The alternative to breast implants

Nowadays, BIA-ALCL risk can be avoided by choosing solutions other than breast implants. Adipose-Derived Stem Cells (ADSCs) are the best option. They ensure the best results, together with the highest safety levels and the lower risk of adverse effects.

ADSCs come with a double benefit: breast remodelling and excess fat reduction. In fact, ADSCs can be obtained from a patient’s excess fat (for example, fat accumulated on abdomen or thighs). Following isolation, stem cells are multiplied in the lab to obtain the number needed for breast re-modelling and/or augmentation. That means that this treatment is different from the classical fat or Stromal Vascular Fraction (SVF) transplantation, which do not involve stem cell isolation and expansion.

Clinical studies by Bioscience Institute demonstrated that, if injected in a suitable concentration, ADSCs are not associated with adverse effects such as the necrosis (death) of the injected fat (and, as a consequence, the reduction of the volume achieved by the injection) and cyst develop-ment. The treatment enables significant and durable breast volume augmentation.

For further information on ADSCs-based breast augmentation, please visit LIPOSKILL PLUS webpage, contact us at +971 (0)4 375 722, or send us an email at info@bioinst.com. Our biologist will answer your questions without commitment on your part.

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