Does any surgeon test for BIA ALCL CD 30 aspiration and send implants to pathology? Breast Implant Illness? (Photo)

As you know, Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA ALCL) is a rare T cell lymphoma that can develop after breast implants. It appears to present mainly in women with textured breast implants, and typically presents as a late onset seroma. I completely understand wanting to remove your implants and not wanting new ones placed. I see the rash and skin changes in the photos, but there are a lot of unanswered questions, such as what symptoms you noticed and when,when you had your breast augmentation, what type of implants, where they were placed, what your work up has been thus far, what findings you have on exam, and what imaging you have had if any. The photos are helpful but not nearly enough information is provided to give you comprehensive guidance, or even a diagnosis. If you are planning for implant removal regardless, if there is any suspicion of ALCL, then the implant and capsule should be removed as well as any periprosthetic fluid. In the case of BIA ALCL, your care would involve a multi-disciplinary team, not just a plastic surgeon. Can someone get an illness following breast implants? Yes. Do surgeons, or the medical community in general, think breast implants make all women sick? No. 

Yes, this is standard for suspicion for ALCL.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

hello donnadybdal  Current medical information does not demonstrate an increased risk of breast cancer in women who have breast implant surgery for either cosmetic or reconstructive purposes.  Individuals with a personal history or family history of breast cancer may be at a higher risk of developing breast cancer than a woman with no family history of this disease.  It is recommended that all women perform periodic self-examination of their breasts, undergo routine mammography according to American Cancer Society guidelines, and seek professional care should a breast lump be detected.  In the event that suspicious tissue is identified prior to or during breast surgery, additional tests and therapy with corresponding expenses may be warranted. #options #aspiration  

Thank you for your pictures and questions. There are tests for ALCL but understand that this is very rare and likely not the cause of your problems. In addition, the implants can be sent to pathology, but there is no "test" to check for implant illness. Also, I would suggest you temper your opinions regarding implant illness and surgeons and just concentrate on your goals of having the implants removed.Good luck!

BIA ALCL (breast implant associated anaplastic large cell lymphoma) is very rare, and is presents with fluid around the implant which causes the breast to swell. This fluid can be sent for a special test called “CD-30”, which your doctor must make sure the pathologist is experienced in breast seroma related cytometry so they could make the diagnosis. It’s even better to remove the entire capsule (complete capsulectomy), because why the heck do you have a late seroma anyway? Biofilm? Implant rupture? All great reasons for capsulectomy. Not only does it diagnose the ALCL, but it is also the cure. That’s right, no radiation or chemotherapy, but the entire capsule and implant must be removed. 
Meanwhile, back to your question, you have a whole torso rash and you clearly have some inflammatory process going on, especially where the skin of the breasts rub. Certainly you can remove the implants, but don’t forget there are more common reasons to have a rash, like skin exposure to allergens or something you are ingesting. Finally I hate to mention it but I’ve removed a few saline implants where the surgeons had put chemicals like betadine or steroids in the bag... no doubt to be helpful... but did not help the patient long term.

I see several patients a week for Breast Implant Illness.  They each are treated on a case by case basis.  You always have the ability to send fluid from the operating room if it is encountered.  Most likely this is not the case for you based on your appearance.  A physical exam would be necessary.  All of the cases I do have en bloc capsulectomy, cultures and portions go to pathology.  The implants usually are returned to the patients at their request.

Breast implant illness symptoms are many and varied and similar to autoimmune disease. These are real especially for patients suffering from them. In my experience, the patients that had BII that I did enbloc capsulectomy in most cases did improve and clinical studies have shown this.