Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare cancer of the immune system that can develop in the fluid or scar tissue surrounding a breast implant. It is not breast cancer. The risk is higher with textured implants than with smooth implants. If you have breast implants or are considering breast augmentation, understanding the symptoms and knowing when to seek an evaluation can help you make informed decisions.
What is BIA-ALCL?
BIA-ALCL is a type of non-Hodgkin lymphoma that usually develops in the fluid or scar tissue around a breast implant, sometimes years after surgery. A fluid collection around an implant is not itself a BIA-ALCL diagnosis; it needs evaluation to determine the cause. Most patients diagnosed with BIA-ALCL are treated successfully with surgery, although some need additional treatment if the disease has spread.
What are the symptoms of BIA-ALCL?
The most common symptom is persistent swelling of a breast, often caused by fluid collecting around the implant. Other possible signs include a lump in the breast or armpit, breast pain, a change in shape or size, or unusual firmness. Symptoms often appear years after implant surgery. If you notice a new or persistent change, contact your healthcare provider for an evaluation rather than assuming it is related to normal implant aging.
What is the risk of developing BIA-ALCL?
BIA-ALCL is rare, but the risk is higher for people who have had textured breast implants than for those who have had smooth implants. Risk may also differ among textured implant products, so a single estimate cannot describe everyone’s risk. If you’re unsure which implants you have, your implant card or surgical records may identify the manufacturer and model. Your plastic surgeon can help you understand what that information means for you.
Have there been any deaths due to BIA-ALCL?
Yes. Deaths from BIA-ALCL have been reported, although the condition is rare. Many patients are treated successfully with surgery to remove the implant and surrounding scar capsule, particularly when the disease has not spread. Prompt evaluation of new swelling, a lump, or pain around an implant is important because treatment depends on the diagnosis and extent of the disease.
Can BIA-ALCL occur with saline or silicone breast implants?
Yes. BIA-ALCL has been reported in people with both saline-filled and silicone gel-filled implants. The FDA says the type of filling does not currently appear to be a risk factor; the association is stronger with the implant’s textured outer surface. If you don’t know which type of implant you have, check your implant card or ask your surgeon for your surgical records.
What should I do if I have breast implants?
Continue your recommended breast health care and pay attention to changes around your implants. If you develop persistent swelling, a new lump, pain, or a change in breast shape, contact your healthcare provider for an evaluation.
Although mammograms remain important for breast cancer screening, they serve a different purpose. They do not replace an evaluation of symptoms that could indicate BIA-ALCL.
Why would my surgeon have recommended textured implants for me?
There are two primary reasons your surgeon may have recommended textured surface breast implants. First is that some data has shown a lower rate of capsular contracture (firm scar tissue formation around the implant). Second, all teardrop or anatomic-shaped implants have a textured surface to help hold them in place. Depending on your circumstances, your surgeon may have believed a shaped implant would help achieve your desired result.
How is BIA-ALCL treated, and what is the prognosis?
Treatment for confirmed BIA-ALCL generally involves removing the affected implant and the surrounding scar capsule, along with any associated mass. Many patients need no further treatment after surgery, particularly when the disease is confined to the area around the implant. If it has spread, additional treatment such as chemotherapy or radiation may be needed. Your care team will recommend treatment based on the findings from your evaluation and the extent of the disease.
Should patients have their implants removed because of the risk of BIA-ALCL?
The FDA does not recommend removing breast implants solely because of the risk of BIA-ALCL if you have no symptoms. This guidance also applies to patients with textured implants affected by the Allergan BIOCELL recall.
If you notice swelling, a lump, pain, or another change around an implant, contact your healthcare provider for an evaluation. You can also discuss implant removal or revision with your plastic surgeon if you have concerns about your implants or were already considering another surgery.
Is routine screening for BIA-ALCL recommended?
There is no routine screening test for BIA-ALCL in people who have no symptoms. The expert opinion is that asymptomatic women without breast changes do not require more than routine mammograms and breast exams. But if a patient experiences a change in her breasts – especially if there is swelling or a lump – she should undergo immediate examination, imaging, and consultation with a plastic surgeon. If there is fluid around the implant, the fluid should be aspirated under ultrasound guidance and sent for analysis.
What causes BIA-ALCL?
The exact cause of BIA-ALCL is not fully understood. The strongest established association is with textured breast implants. Researchers are studying whether other factors help explain why only a small number of patients develop the disease, including:
- Differences in implant surface texture
- Inflammation around the implant, potentially involving bacteria
- Individual genetic susceptibility
- The length of time since implantation
These are areas of research, not four conditions that must all be present for BIA-ALCL to develop.
Have Questions About Your Breast Implants?
If you’ve noticed a change in your breasts or have questions about your implant type, call us at (734) 712-2323 or request a consultation online with a Center for Plastic Surgery Ann Arbor surgeon. We can review your concerns and help you understand the appropriate next steps.
This blog post was originally published in December 2020 and updated in September 2026.
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