MY ‘SAFE’ BOOB JOB GAVE ME CANCER:
EXCLUSIVE: The first patient to speak out on the scandal linking Britain’s most popular breast implant to potentially deadly tumours in more than 150 women
AIt’s made me realise this surgery isn’t worth the risk
MOTHER of three diagnosed with a new form of cancer linked to breast implants has revealed the terrible moment doctors told her she had the disease. In an exclusive interview, Adele Jenner – the first patient involved in the new cancer scandal to speak out – said surgeons missed the warning signs after she sought help.
Adele, 39, of Waterlooville, Hampshire, underwent breast augmentation surgery in 2002, three years after the birth of her second child, Cameron. The operation took her from a 34B to a modest 34D.
Having breastfed both Cameron and her daughter Mia, she felt unhappy with her figure. ‘ My breasts had lost their fullness and I longed for my figure to return to normal,’ she says. ‘My husband loved me anyway but I no longer felt confident and didn’t even feel totally happy with how I looked in clothes.’
Today though, having been forced to undergo gruelling chemotherapy and radiotherapy, Adele bitterly regrets her decision. ‘When I was diagnosed, the doctors were considering giving me a full mastectomy. Thankfully, this wasn’t necessary. But if I’d known having my breasts enlarged carried any chance of having cancer, I’d never have done it.
‘I thought this sort of cosmetic surgery was safe. Finding out I had this cancer – and that the implants were to blame – has been devastating.’
Cases of the implant-related cancer, called anaplastic large cell lymphoma (ALCL), have risen sharply since the first case was reported in 1997, according to researchers studying the disease.
Earlier this month, it emerged that more than 150 patients have been diagnosed with ALCL.
Cosmetic surgeons have been quick to point out that the cancer is ‘extremely rare’. Most patients have had surgery to remove and replace the infected implants, and in the minority of cases, chemotherapy or radiotherapy was required.
HOWEVER, some suffered a more invasive form of the disease, with tumours in the breast and elsewhere. Three women are said to have died as a result of the cancer, which would mean a five per cent fatality rate.
One senior oncologist, who asked not to be named but who has examined the available research, said: ‘It seems there is a long latency period – of at least ten years – before the disease starts to cause problems. Until recently doctors won’t have known to look for it in implants that have been removed, so it won’t have been recognised.
‘Yes, it is rare, but I suspect it will become more widely known. And if you ask women who have implants as part of a reconstruction after breast cancer whether they would accept even a small risk, they might not want to take it. Patients need to be told.’
Adele, who works with husband Stephen, 45, in his construction consultancy business, first started having problems six years after her initial £4,000 implant operation, when she became pregnant with third child Ella.
She says: ‘I breastfed Ella but five weeks after she was born both my breasts suddenly became hard and painful.’ Doctors initially diagnosed mastitis, a common infection in nursing mothers, but after antibiotics failed to resolve the problem, she was referred to a consultant for further tests.
This time, Adele was told she was suffering a side effect known as capsular contractor, which is caused when the body naturally creates a capsule of fibrous scar tissue around the implant. Over time it shrinks, making it feel hard. Although uncomfortable, doctors reassured her it wasn’t harmful.
In fact, it is now known that all women with breast-implant related ALCL have also been suffering from capsular contracture, a common post-surgical complication that affects between six and 10 per cent of ‘boob-job’ operations. This has prompted scientists to suggest that the two conditions are associated.
But given no indication of that she was at any risk, Adele did nothing: ‘My breasts still looked fine so I decided to live with it.’ A year later, the couple had saved the £4,000 necessary for Adele to have a replacement implant operation. Yet worryingly, she says her breasts felt the same. ‘The surgeon said it was because they were swollen but as soon as I came round I knew they weren’t right.’
Adele later discovered the surgeon had simply replaced the silicone prostheses and had not removed the fibrous capsule, as should have been routine in this kind of procedure.
Dissatisfied – but still not aware she was in any serious danger – it wasn’t until August 2012 that Adele had saved enough money to have the implants replaced again during an operation in Belgium. ‘This time my breasts were soft and completely normal. It was a huge relief,’ says Adele.
However, two days later she found a hard pea-sized lump on the side of her right breast under her arm.
‘The doctor said it was simply where I’d been cut,’ she says, ‘and when I came home my GP said he thought it was just scar tissue.’
Yet by December that year, during a family holiday to Florida, she noticed the lump had doubled in size and was painful. Adele was later referred to a hospital where doctors decided to operate.
TWO weeks later she was called back for the results and says: ‘Nothing could have prepared me for the moment I was told I had cancer. I am slim and fit – I go regularly to the gym – I don’t smoke or drink, and there is no family history of breast cancer. Afterwards Stephen and I sat in the car, hugging and crying. I immediately thought, “Will I see our children grow up?”’
It was only when Adele went for treatment that she discovered she had ALCL. ‘The surgeon explained it was a type of lymphoma, a cancer of the immune system, which usually occurs in the lymph glands. He believed it had been triggered by the breast implants.’
She underwent radiotherapy and chemotherapy, which caused her hair to fall out, but was advised that she did not need a mastectomy or have her implants removed. ‘My oncologist assured me that there was no risk as all the cancerous tissue had been removed in the previous operation to replace the implants. A fourth operation would be unnecessary. Of course, if at any stage there was a chance they could harm me I would have them out.’
Since finishing treatment last July she has been given the all-clear, but still has quarterly check-ups.
Surgeons suggest breast implant associated ALCL is a new form of this type of cancer, and say all women considering a boob-job should be warned of the risk.
The story raises the spectre of the PIP implant scandal, which engulfed the industry three years ago. It was discovered that up to 47,000 British women, and 350,000 worldwide, had been given faulty breast prostheses prone to leaking their gel filling. In fact, the case that first triggered the investigations into PIP was that of a 53-year-old French woman who died from ALCL.
Two years ago, British mother-ofone Susan Grieve, 40, another recipient of a PIP implant, died of ALCL. However, PIP implants have been
deemed to be not toxic. Now, it seems the true risk factor may be a far more common one – textured implants. Silicone breast prostheses are either smooth or have a textured outer shell, the latter being the most commonly used in the UK.
Professor Anand Deva, who is leading an Australian study into ALCL, says: ‘The rougher surface of textured implants provides a better grip to adhere to the surround- ing tissues, so they are less likely to move.’
Despite manufacturer’s claiming that textured implants reduce contracture, clinical studies are divided, and this new research shows that they are more prone to contamination with bacteria, which can result in contracture. ‘Our research has shown contracture is due to a bacterial infection, called a biofilm, around the implant, most likely
introduced at the time of insertion,’ explains Prof Deva. ‘The textured surface provides an ideal breeding ground for bacteria, should they be present. We have shown if simple steps are taken, such as washing out the pocket made in the breast with antibiotics before implant insertion, and changing gloves regularly, then bacterial infection and capsular contracture can be avoided.’
It is currently too early to say whether the bacteria found in textured implants causes ALCL. However, lab studies have shown in cases of contracture, there is increased activity of lymphocytes (immune system cells) around the implant. ‘This may be the prelude to ALCL,’ says Prof Deva.
In 90 per cent of the reported cancer cases, a textured prosthesis was used. These implants were introduced in the Eighties and widely taken up during the Nineties. ‘It would make sense that it took this long for the disease to have emerged,’ adds Prof Deva.
HIS team are currently l ooking at ALCL samples i n their laboratory to detect bacteria and determine if there is a link to bacterial infection and the development of ALCL. They are now part of a growing cooperative effort around the globe to uncover the cause of this cancer.
Prof Deva explains: ‘When they removed breast implants due to capsular contracture before, the tissue was thrown in the bin. Now doctors are obliged to report any patients who come to them with fluid buildup around their implant.’
Adele’s original implants were textured but her current prostheses are smooth. She says: ‘I feel so guilty that wanting the perfect figure has put my family through such turmoil. This has made me realise no cosmetic surgery is worth putting your health at risk. I hope telling my story makes other women think twice before they have breast enlargement surgery.’
Consultant plastic surgeon Fazel Fatah, a former president of the British Association of Aesthetic and Plastic Surgeons (BAAPS), urged women to remain calm.
‘It is important to remember that the number of breast implant patients globally is considered to be higher than 15 million, yet these tumours are extremely rare, treatable, and patients should continue to feel safe,’ he says. ‘There is no need to remove implants unless they develop sudden unexplained changes or swelling.’