Saturday, July 1, 2017

Rare malignancies of immune system studied

Implants may bring a new disease to cancer patients with mastectomies, N.Y. Times says 

Can breast cancer implants give a woman who's had a mastectomy another cancer?

According to a recent article by Denise Grady in The New York Times, the answer is a definite yes.

The new cancer, it indicates, may not be breast cancer "but a rare malignancy of the immune system —  caused by the implants used to rebuild her chest."

The disease, anaplastic large-cell lymphoma, is a cancer that's "been linked to implants with a textured or slightly roughened surface, rather than a smooth covering," the piece says.

Although the federal Food and Drug Administration first reported a link between implants and the disease in 2011, an FDA update in March linked nine deaths to the implants and helped raise awareness, Grady's article notes.  

The FDA has also received 359 voluntary reports of implant-associated lymphoma from doctors or patients around the world.

That number, the story says, "is expected to rise as more doctors and pathologists recognize the connection between the implants and the disease."

As of now, however, no implants have been recalled — and "what's inside the implant, silicone or saline, seems to make no difference."

Between 2000 and 2016, the number of U.S. breast augmentations rose 37 percent — "and reconstruction after mastectomy rose 39 percent," Grady writes.

"Annually, nearly 400,000 women in the United States get breast implants, about 300,000 for cosmetic enlargement and about 100,000 for reconstruction after cancer, according to the American Society of Plastic Surgeons," the story adds.

Lymphoma, if detected early, is often treatable and rarely fatal — although its symptoms "usually include painful swelling and fluid buildup around the implant. Sometimes there are lumps in the breast or armpit."

Dr. Mark W. Clemens II
In cases with bad outcomes, the Times quotes Dr. Mark W. Clemens II, a plastic surgeon and expert on the disease at the University of Texas MD Anderson Cancer Center in Houston, "it was usually because they were not treated or there was a major delay in treatment, on the level of years."

Clemens believes that as late as 2015, "only about 30 percent of plastic surgeons were routinely discussing the cancer with patients," the Times piece says.

The newspaper also notes that what causes the disease isn't known. "One theory," Grady's story postures, "is that bacteria may cling to textured implants and form a coating called a biofilm that stirs up the immune system and causes persistent inflammation, which may eventually lead to lymphoma."

Clemens noted that researchers are also looking for mutations that might contribute to the disease.

More information about women's difficulties after reconstruction can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

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