TeachableMedicalNews article 11072020

Teachable moment in classrooms:

  1. cellular basis of life chapter – gene mutation leading to malfunctioning protein
  2. cellular basis of life chapter – mitosis or somatic cell division
  3. integumentary system chapter – scar tissue formation during dermal wound healing
  4. immune system chapter – lymph nodes as location of lymphocytes
  5. immune system chapter – cell division as part of immune response in lymph nodes.

The news item:  Recently a recall of breast implants was in the news:

Breast implants tied to rare form of cancer recalled at FDA request

Allergan Inc. announces a worldwide recall of implants with a textured surface

The report described how one type of breast implant made by Allergan is associated with the development of a rare cancer, called anaplastic large cell lymphoma (ALCL).

So, Why Do I Care??  Altogether close to 600 anaplastic large cell lymphoma cases have been reported in women with breast implants. Even such a relatively slow number of cancers is a concern, because most of those cases occurred in women with one type of implant. Add to this that breast implants have been considered as a cosmetic alteration that presents little danger, but now a specific disorder is associated with them. That is a substantial change in how we view the risks of this procedure

Plain English, Please!!!

First, let’s talk about how a breast implant affects the body. This cosmetic implant is made of plastic, and it is surgically inserted under the skin. The normal wound healing process forms a scar tissue around the implant. That scar tissue is the location of the ALCL in women with Allergan breast implants.

Second, let’s talk about what lymphoma is. Normally, when our immune system responds to pathogens that invade our body, the B lymphocytes and T lymphocytes act like copy machines, and they make millions of copies themselves inside lymph nodes and other lymphatic organs. Once the invader is eliminated the copy machines are turned off. Sometime, however, the copy machine’s switch is stuck in the ”ON” position, and the uncontrolled cell division by the B lymphocytes and T lymphocytes lead to the cancers called lymphomas.

Third, let’s talk about how this breast implant may be causing lymphoma.  In ALCL the T lymphocytes divide out of control within the scar tissue around the implant. What could turn those normally quiet T lymphocytes into active copy machines?  Mutations have been identified in the DNA of cancerous T lymphocytes, and mutated DNA will be translated into faulty proteins that allow uncontrolled cell division. Such faulty proteins move the copy machine switch from the “OFF” position into the “ON” position in those lymphocytes.  Just what from the implants is causing the mutations is currently unclear.

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