Hundreds of cases have been diagnosed, now the FDA wants physicians to be on the lookout.

Officials from the U.S. Food and Drug Administration (FDA) are warning that they are seeing more cases of a rare cancer linked to breast implants and they want doctors to be on the lookout for warning signs.

The cancer is a type of lymphoma called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

The FDA reports that at least 457 people have developed the disease and nine have died since the ailment was first reported in 2011.

This lymphoma is a type of non-Hodgkin’s lymphoma, which means it’s a cancer that affects immune system cells.

The disease can occur in multiple parts of the body, including the lymph nodes and skin. While it can occur in breast tissue, it isn’t breast cancer.

The FDA already had advice for plastic surgeons, but now they want other physicians including radiologists, ER physicians, internal medicine physicians, and OB-GYNs to be on the lookout for certain warning signs.

In a statement to healthcare providers, the FDA said they want doctors to consider if BIA-ALCL is an option when a patient presents with a peri-implant seroma or fluid collection.

The steps they want physicians to take include collecting fluid and sending it to a pathologist to look for signs of cancer. Additionally, if they see masses around an implant, they want them to consider the possibility it is BIA-ALCL.

In terms of silicone versus saline, there appears to be little difference in the risks of developing the disease.

However, health experts have found that most patients who develop the disease are more likely to have textured implants instead of smooth.

It’s hard to discern how often people develop the disease, but the FDA estimates that 1 in 3,817 to 30,000 women with textured breast implants are at risk of developing the cancer.

Dr. Alice Police, Westchester County regional director of breast surgery at Northwell Health Cancer Institute in New York, said experts aren’t sure why some patients develop the disease, but it may be that the body rejects the foreign object.

“We don’t really know exactly what the mechanism is,” she told Healthline. “The thought is that the textured implants are very irritating to the tissue and cause a lot of tissue reaction that may lead to a malignancy.”

The FDA reported that fluid buildup and irritation are among the first signs of the disease.

“It usually occurs as fluid around the implant and what people first notice is an inflammation of the breast,” Police explained.

The disease often appears years after the implant operation, so patients who’ve had the surgery should note if anything around the surgical area changes.

Police said patients “who have pain and swelling several years after the placement of their implants” should see their doctor and get tested for the disease.

Police stresses that the number of cases is small.

Removing breast implants from people who don’t have symptoms could put them at unnecessary risks for other surgical complications.

“We’re currently not recommending that asymptomatic women with breast implants go and have their breast implants removed,” she said.

While there appears to be a risk, the number of cases reported is a tiny fraction of the number of people who’ve had breast implants.

Police said that the disease is rare, so people with breast implants or those seeking them shouldn’t be overly concerned about the risk of developing that disease.

“The good news is that a vast majority of patients with implants have nothing to worry about. This is a very, very, small number. It’s one-tenth of a percent at most,” Police said.

However, Police said patients should talk to their surgeon to understand if they generally use smooth or textured implants.

“I do think patients who are going to get implants should not get the textured implants,” she said.

Police said she does discourage women from getting cosmetically enhanced breasts, although not due to the lymphoma.

Police said she is concerned that many patients have general complications like a ruptured implant that can require further surgery.

“The idea that you can get these big breasts easily that will transform your life with no complications or problems — a sort of free lunch — has never been an idea that sits well with me,” she said.