I Got Implants After Surviving Breast Cancer Twice

December 12, 2019

Diana Cavallo was no stranger to breast cancer. Her mother died of the disease, and Cavallo herself was diagnosed with breast cancer at the age of 44 and again at 49.

Cavallo, 58, was first diagnosed with ductal carcinoma – a type of breast cancer that begins in the ductal cells of the breast – in 2005. At the time, her recommended treatment was a mastectomy, which involves removing the cancer from her right breast. She then underwent seven weeks of radiation therapy, which put her in remission.

But “for almost five years, for some reason, I had a bad feeling that the cancer was coming back,” Cavallo told Health.com. It was – “in pretty much the exact same spot,” she said. In 2010, she was diagnosed with breast cancer again – this time with ductal cancer, as before, and lobular cancer, which affects the lobules in the milk-producing and emptying milk ducts.

For her second breast cancer, Cavallo underwent a double mastectomy, which is the removal of both breasts. She decided to have a breast augmentation at the same time, so in a December 2010 surgery, Cavallo’s breast tissue was removed and her silicone implant placed.Six years later, in 2016, Cavallo had the silicone implant in her right breast removed and replaced with a textured implant. She made the change because the textured implant reportedly adheres better to the skin, and the silicone implant in her right breast did not do a good job of that.

Three years later, Cavallo learned that her textured implants were linked to other women’s cancers
Cavallo first discovered the link between some textured breast implants and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) in May after seeing multiple news reports about the link.In July, the FDA requested a recall of textured breast implants made by Allergan, which Allergan agreed to, and the association Becoming even more concerning.Cavallo’s specific type of textured implant – the Natrelle 410 highly cohesive anatomically shaped silicone filled breast implant – is on the FDA’s list of affected products.

According to the FDA, 33 patient deaths have been linked to BIA-ALCL since 2010, while 573 cases of BIA-ALCL have been reported worldwide. However, to be clear, BIA-ALCL is not breast cancer. Rather, it is a type of non-Hodgkin’s lymphoma, or cancer of the immune system, per the FDA. for most patients with BIA-ALCL, lymphoma cells are found in one of two places. In the fluid around the breast implant or in the fibrous scar sac, according to the FDA – these two specific areas are separate from the breast tissue, where breast cancer is usually found.

The main symptom of BIA-ALCL is persistent swelling or pain around the breast.” These symptoms may occur after the surgical incision has healed, usually years after the implant has been placed,” warns an FDA statement. For most people with BIA-ALCL, the cancer is successfully treated by removing the textured implant and surrounding scar tissue. However, the FDA notes that some patients will require chemotherapy and radiation therapy.

However, the odds of developing BIA-ALCL in the first place are slim, Andrew Salzberg, a plastic and reconstructive surgeon at Mount Sinai Health System in New York City, who performed the surgery on Cavallo, told Health.” This is definitely a rare case. There are only about 600 reported cases in the world and [there are] about 75,000 patients with textured implants right now.”

The U.S. Food and Drug Administration also outlined the low risk in a statement released in July, but still explained their rationale for recalling specific breast implants.” While the overall incidence of BIA-ALCL appears to be relatively low, once the evidence showed that a particular manufacturer’s product appeared to be directly linked to significant patient harm, including death, the FDA acted to alert the company to new evidence that the recall was necessary to protect women’s health,” said Amy Abernethy, MD, PhD, chief deputy commissioner of the FDA, in the press release .

It is important to note: While the government has requested a recall of the affected Allergen textured implants and urged their removal from shelves and future procedures, the FDA does not recommend that women remove the recalled Allergan textured implants unless they experience symptoms of BIA-ALCL.” If you don’t have symptoms, we don’t recommend removing the implant…. . due to concerns related to the risk of developing BIA-ALCL,” the FDA statement said.

Dr. Salzberg says there could be many reasons for this. One is to reduce the risk of harm to the body.Dr. Salzberg says, “We don’t want to open everyone up to the cost and risk of surgery.” That can lead to infection, bleeding and anesthesia problems. He adds that surgery can be more risky than leaving an implant behind.

Another problem. Experts don’t yet know if having the implant removed reduces a person’s risk of developing BIA-ALCL, Dr. Salzberg said.

Despite the rarity of BIA-ALCL and the risks associated with removing the implant, Cavallo isn’t the only one worried about getting cancer again – which is why she took action.
“Many, many patients become alarmed when they see the news,” says Dr. Salzberg. He explains how Mount Sinai patients who have the implants are notified.” We’re calling you to say that you’ve been identified as having the device and you know what your risk is. Obviously, people are freaking out about it.”

Those most concerned include women who have undergone mastectomies and had implants inserted for breast cancer, and Cavallo is one of those patients – which is why she recently opted to have her Allergan implant removed, despite having no symptoms of BIA-ALCL.” I have two children. If I don’t get [it] out and I get cancer, I’m going to kick myself, Cavallo told Health before her Aug. 29 surgery.” No one wants to be cut, [but] I’m fighting to stay alive.”

Her comments echo those Dr. Salzberg has been receiving from patients who have used the recalled implants since the recall was announced.” Patients [say], ‘I know I’m the one who’s going to get it. My luck,'” said Dr. Salzberg.” She felt that if it was going to happen to anyone, it was going to happen to her.” (It should be clarified, however, that a woman’s history of breast cancer does not increase her risk of developing BIA-ALCL, Dr. Salzberg says.)

Cavallo says it’s frustrating when the media and doctors emphasize how rare BIA-ALCL is.” It hits close to home when you’ve already had your breasts cut out.”

In the end, having the breast implants removed gave Cavallo peace of mind – she was confident in her decision.
Cavallo’s recovery time from surgery can take up to eight weeks. But that’s nothing compared to the relief of having the implant removed.” Recuperating [is] not a day at the park, but I’ll wait for the other shoe to drop.”

Overall, Cavallo says women need to be aware of the risks associated with the Allergan implant, which is why she’s telling her story. She explains that she believes that her lifestyle minimizes her risk of cancer.” I don’t smoke. I don’t drink, I’m vegan. I’m vegan. I don’t want anything in my body that’s going to cause [cancer],” she said. So, for her, removing her implants was the only sensible option. Cavallo has another implant insert where she recycles Allergan textured implants, which she has removed.

Dr. Salzberg agreed that the decision to remove these textured implants without any symptoms of BIA-ALCL was a personal decision made by the women affected. He said he tells patients with implants to “go home and think about it and make your best decision. If you can’t tolerate [your implants], let me know. A removal procedure is certainly not an open-heart surgery.”

For Cavallo, her personal decision was made against the FDA’s advice – and it’s something she wants all women to be able to exercise.” Knowledge is power, [and] it’s a personal choice. Women have the right to choose.” The decision to remove the implant was the right choice for her.” I was relieved that the implant came out of my body,” she said, the day after her surgery.” I’m glad I made the decision.”