Textured Breast Implants and BRCA Mutations Increase Lymphoma Risk in Women

Women with breast cancer who carry mutations in the BRCA1 or BRCA2 gene and undergo reconstruction with textured breast implants face a substantially higher risk of developing breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), according to new research. The study, published in Blood Advances, found these women were 16 times more likely to develop BIA-ALCL compared with those without these genetic mutations.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)

A rare type of T-cell lymphoma that develops in the tissue surrounding breast implants, primarily textured implants. It usually appears as a fluid collection or mass and can arise many years after implantation.

BRCA1 and BRCA2 mutations are already well known to increase the risk of breast and several other cancers. However, this is the first large study to examine whether these mutations also contribute to the risk of BIA-ALCL, a rare T-cell lymphoma linked to textured breast implants.

A higher risk confirmed

The study drew on a long-term cohort of over 3,000 breast cancer survivors treated at Memorial Sloan Kettering Cancer Center (MSKCC) who had undergone reconstructive surgery with breast implants. Of this group, 520 women were tested for BRCA mutations. Researchers compared the rate of BIA-ALCL between women with and without BRCA1 or BRCA2 mutations who received textured implants.

Women were followed for a median of 11.5 years. Among the 520 women tested, 43 (8.3%) carried BRCA1 or BRCA2 mutations. The researchers found that the age-adjusted incidence of BIA-ALCL in this group was 16 times higher than in women without these mutations.

“Our findings show that BRCA1 and BRCA2 mutations are a significant risk factor for developing this type of lymphoma, confirming earlier suggestions of a possible role. It’s possible that implant-associated lymphoma is yet another cancer that can arise because of these genetic mutations.”

Dr. Paola Ghione.

The team also performed a case-control analysis of 13 BIA-ALCL cases matched with 39 controls. The frequency of BRCA mutations in the lymphoma cases was significantly higher than in the matched controls.

Context for BIA-ALCL risk

Previous studies have shown that textured breast implants, now recalled in the United States and Europe, are associated with BIA-ALCL. The lymphoma typically develops 7 to 10 years after implant placement, manifesting as a fluid collection or mass near the implant.

In 2023, the US Food and Drug Administration reported 1,264 cases and 63 deaths related to BIA-ALCL. Textured implants accounted for about 12% of US reconstructive surgeries but were used in up to 95% of procedures in Europe.

Importantly, the study found no link between BIA-ALCL risk and other variables such as implant filling type (saline or silicone), patient age at surgery, or prior cancer treatments such as radiation or chemotherapy.

Implications for breast cancer survivors

Given the large number of women who still have textured implants in place, the researchers recommend that breast cancer survivors be aware of the type of implant they have and discuss this with their medical team. Women with a personal or family history of breast cancer, particularly those diagnosed at younger ages, may wish to pursue genetic testing to better understand their risks.

“If we look at the absolute numbers [seen in this study], it’s still fairly rare, but the important thing to note is that when we look at women with this genetic predisposition, there is a big jump in the percentage with this lymphoma.”

Dr. Paola Ghione.

Routine removal of implants is not currently recommended by the FDA unless symptoms arise. Symptoms of BIA-ALCL can include pain, swelling, lumps or changes in breast shape.

The study did not assess women with BRCA mutations who underwent prophylactic mastectomy to prevent breast cancer. The MSKCC team plans to continue monitoring their cohort, including women who have since had their textured implants removed.

Although this was a single-institution study, its findings underscore the importance of long-term follow up and informed decision-making for women with breast cancer considering or living with breast implants.

Reference: Ghione P, Mandelker D, Arcila ME, et al. BRCA1/2 impact on the development of implant-associated lymphoma in women with breast cancer and textured implants. Blood Adv. 2025:bloodadvances.2025016810. doi: 10.1182/bloodadvances.2025016810

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