Macquarie University. Australia: New research has revealed that infection by bacteria on the surface
of textured breast implants may increase women’s risk of developing a
rare type of cancer – newly designated as breast implant associated
anaplastic large cell lymphoma (BIA-ALCL).
Previous studies led by Associate Professor Anand Deva of Macquarie
University’s Australian School of Advanced Medicine have found that
bacteria which live in clumps attached to breast implants (termed
biofilm), is a major cause of capsular contracture. Contracture is a
painful hardening of the tissue around the implant that can cause
physical deformity, pain and is the most common cause for revision
surgery following breast augmentation.
Professor Deva’s latest study has
found that the chronic infection around these infected implants can also
lead to an activation of the immune system and the patient’s
lymphocytes. Long-term stimulation of lymphocytes by this infection may
be the stimulus for the transformation of these cells into BIA-ALCL. The
infection was shown to be highest around textured breast implants and
this may provide an explanation as to why BIA-ALCL seems to be more
commonly seen in patients with textured implants.
“Our previous research has shown that
24 hours after bacteria come into contact with breast implants, textured
implants had 72 times the number of bacteria attached to their surface
as compared with the smooth implants,” said Deva.
“This latest study has shown that the textured implants with the
highest numbers of bacteria also had the highest number of activated
lymphocytes around them. This finding is important and has now become
even more relevant since the reporting of BIA-ALCL as it provides us
with a possible biological explanation of how this rare cancer could
arise.”
Professor Deva and his team in
association with Dr. William P Adams from UT Southwestern in Texas, have
had published a 14-step guide to reduce the risk of breast implant
infection (“The Role of Bacterial Biofilms in Device-Associated
Infection” Plastic and Reconstructive Surgery, November 2013, page
1323), based on evidence of best practice to educate surgeons on how to
reduce the risk of bacterial contamination. A number of clinical studies
have applied these principles of reducing bacterial contamination and
successfully reduced the rate of capsular contracture by a factor of 10
in their patients.
“This is a great validation of our research and a demonstration that
good science in the laboratory can be translated into real benefits to
patients at the bedside. Now with our greater understanding of the
importance of preventing infection, we, as surgeons, can reduce the risk
of capsular contracture and thereby reduce the risk of lymphocyte
activation and possible transformation into BIA-ALCL,” said Deva.
Deva, Anand. Chronic
biofilm infection in breast implants is associated with an increased T
cell lymphocytic infiltrate – implications for breast implant associated
lymphoma, Plastic and Reconstructive Surgery, the Journal of the American Society of Plastic Surgeons (PRSJournal.com)