'It's like a bomb in their chest': N.B. woman heads to Montreal to reduce her risk of breast cancer a second time

For Chrissy Powers, it was empowering to feel she had outsmarted breast cancer.

After an extensive family history of breast cancer, in 2016, the New Brunswick woman underwent genetic testing which confirmed she had the BRCA 2 gene mutation which made her chances of developing breast cancer as high as 85 per cent.

In 2018, Powers received bilateral mastectomies and an immediate reconstruction with silicone implants.

“I remember feeling at that time that this is incredible how far scientists came that you can get in front of this. And who wouldn't want to take, you know, the necessary measures to reduce the risk of getting and developing breast cancer?” she said in an interview with CTV Atlantic from her Fredericton home. “In an odd way of thinking, I felt like I won the lotto, right? Like, my goodness, I've avoided this.”

Two years later, Powers says she started to experience “severe” swelling in one breast, along with a rash. By the time she saw her plastic surgeon six months later, the pain and rash had subsided.

But in August, 2023, it returned.

“I had simply rolled over in bed and felt that I had rolled onto something hard. And I get up the next morning and notice that my breast is double, if not more than double in size and felt very hard to touch and felt very high on my chest. Quite painful,” she recalled. “I knew something was wrong and went in to see my family physician who sent me for some testing, which then confirmed excess of large amounts of fluid that were surrounding the implant.”

She was also experiencing a host of other symptoms: brain fog, memory loss, joint and muscle pain, depression, anxiety and blurred vision.

Chrissy Powers is going to Montreal for a surgery to reduce her risk of breast cancer. (Courtesy: Chrissy Powers)While waiting to get a follow-up MRI, Powers did what most do – turned to the internet.

She discovered two things: a community of thousands of women with what’s known as breast implant illness or ‘BII’– and a 2019 Health Canada recall notice for “Allergan Biocell breast implants.”

“I learned that those particular brand of implants are linked to lymphoma cancer called BIA-ALCL, which stands for ‘Breast implant-associated anaplastic large cell lymphoma,’” she said. “Immediately I'm thinking, ‘My gosh, I hope I don't have that brand of implant, because how crazy would that be to go through all the steps I've gone through to eliminate cancer, to turn around and have implants put in that are known for this man-made cancer is what they call it.’”

According to the Health Canada recall notice and subsequent suspension of that type of implant, the federal agency states that “BIA-ALCL is a serious but rare type of non-Hodgkin lymphoma…that may develop many months or years after a breast implant procedure. It is not a cancer of the breast tissue. BIA-ALCL usually presents as an accumulation of fluid (known as seroma fluid) between the implant and the surrounding tissue.”

The notice also states that while the cause of BIA-ALCL is unknown, risk factors include high-surface area of the implants, genetic factors and long-term inflammation around the implant.

Health Canada has received 64 confirmed cases in Canada of the lymphoma. Three of those people have died. Of the 64 cases, 51 involved the specific type of textured implants, the agency said in an email to CTV.

Powers says her plastic surgeon confirmed in November she had those textured implants.

“I was feeling, you know, scared, confused, frustrated, like, why was I not made aware of this recall?” she asked. “Nissan, Ford, you have a vehicle, you're notified if there is a recall on your vehicle. But medical devices with serial numbers don't have that same requirement? Like, I was dumbfounded. Like, why? Why is that not a requirement to share that information with patients?”

According to Health Canada, the risk of BIA-ALCL has been communicated to the public through advisories and “distributed documentation that health care professionals are to share with patients and their families.”

Removing the risk, yet again

Powers reiterates she may not have the lymphoma – her MRI results have been inconclusive so far, and she needs further testing done of the fluid surrounding the implant.

But she’s concerned that testing – and scheduling an explant surgery to remove the implants – could take months, she says, if she gets it done in New Brunswick.

According to provincial data, five out of 10 patients wait 223 days for plastic surgery – reconstructive and cosmetic - in the Fredericton area. Nine out of 10 wait 368 days.

And she doesn’t want to take the risk. So, through her research, she found Dr. Stephen Nicolaidis, a plastic surgeon in Montreal.

Nicolaidis said he started noticing more and more women coming to him wanting their implants removed in 2018. By 2021, his practice had become solely explant surgeries – and studying the illnesses behind them.

Dr. Stephen Nicolaidis, a plastic surgeon in Montreal, is pictured. (Source: CTV News Atlantic)In an interview with CTV Atlantic from an operating room in Montreal, he clarified Breast Implant Illness and BIA-ALCL are entirely different.

“Breast implant illness is a cohort of numerous symptoms that arise with any implants…it’s now recognized by the FDA, it’s a warning that have to be put now on all breast implant boxes to tell patients that there is a subset of patients who will become ill from their implants,” he explained.

He says statistically, it’s hard to determine how many people will come down with the illness, but the estimate is between five and 10 per cent of patients. Studies show many patients do get better once the implants are removed, Dr. Nicolaidis confirmed.

The lymphoma known as BIA-ALCL is solely caused by textured implants, he says, and is relatively new – only discovered about eight years ago.

“At the time we thought the incidence of the lymphoma is like one in a million. So it was felt to be super rare,” he said. “Since we identified this lymphoma, we've now realized that the lymphoma is a lot more frequent than we thought, which always happens when you have a new diagnosis of something. And unfortunately, with the very textured implants, it's now one in 400.”

Nicolaidis says some patients describe it as a “bomb in their chest, waiting to go off.”

He has scheduled Powers for the explant surgery on Jan. 19, but because it will be done in his clinic and not a hospital – it won’t be covered by N.B. Medicare, says Powers.

So, she’s taken out a loan to pay for the surgery, not wanting to wait any longer than she has to.

The total: $15,090.00 not including travel and accommodations while in Montreal.

The tissue surrounding the implant will be studied and tested to see if it has developed BIA-ALCL.

“Imagine the irony of this. She's had the prophylactic mastectomy to decrease her chances of getting the cancer. They put the implants in…but now she has a one in 400 chance of getting a lymphoma,” he said, of Powers’ case.

Nicolaidis is encouraging anyone who suspects they have textured implants to contact their family doctor and/or plastic surgeon.

Breast implants are pictured. (Source: CTV News Atlantic)

'Knowledge is power,' says Powers

Two days before her explant surgery, Powers says she’s nervous, but excited. She’s hopeful, once removed, many of her symptoms will go away too. As well as the risk of the lymphoma.

“I've already ordered my prostheses. I've already ordered my mastectomy bras. For me, I felt like that was helping to plan for after I'm healed. I don't want to remain flat, you know. I know many women do. I would like to try the, you know, prostheses and see how I feel with those,” she said.

She doesn’t want to paint every medical device with the same brush – but after her journey, she believes knowledge is power.

Powers wants more women to be aware of breast implant illness, and know they’re not “crazy” if they’re experiencing a number of different symptoms after getting implants.

“Like, if I could turn back time, would I have gone through with the double mastectomy, the bilateral mastectomies? Absolutely. I would have removed my breast tissue. No question. Would I have had implants put in? Absolutely not. I never would have put these implants in, knowing what I know today,” she said. “I think that that's really why I wanted to share my message today with the hope that even if my story could help even one other woman, then it's worth, you know, being vulnerable.”

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