Criticism emerges from downplay of breast implant risk

When talking to patients about a rare type of cancer linked to breast implants, plastic surgeons should call it “a condition” and avoid using the words cancer, tumor, disease or malignancy, the president of the American Society of Plastic Surgeons advised members during an online seminar on Feb. 3.

The comments, by Dr. Phil Haeck, the society president, were made public on Thursday by Public Citizen’s Health Research Group, an advocacy group in Washington. The group also wrote to the Food and Drug Administration, characterizing the advice as part of a misinformation campaign devised to play down the risks of implants, and urging health officials to put a stop to it.

Haeck was traveling and not available for an interview, according to a spokesman for the plastic surgeons’ group, which issued a statement responding to Public Citizen’s claims.

The surgeons’ group said Public Citizen had taken Haeck’s remarks out of context and misconstrued them. He was discussing a possible link between the implants and anaplastic large-cell lymphoma or ALCL, a cancer that involves the immune system.

The events grew out of an announcement on Jan. 26 by the Food and Drug Administration that breast implants might cause a small but significant increase in the lymphoma, which is rare but treatable. It is not breast cancer. It is usually a systemic disease, but in the cases linked to implants, the lymphoma grew in the breast, usually in the capsule of scar tissue around the implant.

Though some evidence suggests that the lymphoma associated with implants might be less aggressive than the more common form of the disease, that evidence is not conclusive, said Dr. William Maisel ’88, the chief scientist and deputy director for science in the Center for Devices and Radiological Health at the Food and Drug Administration.

The disease is exceedingly rare. At the time of the January announcement, the drug agency said it knew of only about 60 cases worldwide, a tiny number compared with the 5 million to 10 million women who have implants. But even that small number appears to be an excess of cases when compared with the usual incidence in the breast of this type of lymphoma in women who do not have implants: 3 in 100 million.

In some cases simply removing the implant and scar tissue appeared to eliminate the disease, but in others women were given chemotherapy or radiation, or both.

The Food and Drug Administration issued a statement saying it was reviewing Public Citizen’s letter.

The agency has said that women with implants should pay attention to changes in their breasts and see a doctor if swelling, lumps, pain, asymmetry or other symptoms develop. The lymphoma can occur years after the implant surgery.