Nine people may have died from a rare cancer linked to breast implants, according to the Food and Drug Administration. However, the deaths did not occur because of breast cancer — instead, they were caused by a rare immune-system malignancy that grows in the breast, inside the scar tissue that forms around the implants, the New York Times reports.
The FDA first linked breast implants to anaplastic large-cell lymphoma back in 2011, and received 359 total reports of cancer linked to the implants as of February 1, according to the Times. This specific form of cancer is typically treatable and not fatal, and is most likely to occurred with textured implants (that have “a pebbly surface”) than with smooth implants, the FDA said.
“All of the information to date suggests that women with breast implants have a very low but increased risk of developing ALCL compared to women who do not have breast implants,” the FDA said in a statement.
Only 231 of the 359 reported cancer cases included information about the type of implant surface: 28 were smooth implants, while 203 were textured. The Times notes that the contents of the implants seems to be far less important than the texture, because of 312 cases where the contents were known, 126 were filled with saline and 186 were filled with silicone gel. These cancer cases are usually only detected after symptoms appear — such as swelling, fluid buildup, pain, and lumps.
The FDA notes that it is unclear how many cases of implant-related cancer exist due to a lack of data and reporting problems. However, usually when the lymphoma pops up, simply removing the implant and surrounding tissue eliminates the disease, though some women may need chemotherapy and radiation, as well.
It’s not yet known why the difference in cancer risk associated with the surfaces exists, but Dr. Alex K. Wong, a plastic surgeon and researcher at the University of Southern California’s Keck School of Medicine, told the Times that the body has a different reaction to textured implants, and that tissue grows into “microscopic groves” in those implants.
“When we take these out, you can hear a peeling sound,” Dr. Wong told the Times. “Whereas with a smooth implant, it’s like Jell-O. You can spin it around. It moves really easily.”
American Society of Plastic Surgeons’ data shows that nearly 290,000 women in the U.S. got implants to enlarge their breasts in 2016, while 109,000 had them for reconstruction following breast cancer, the Times reports.