Response to “The Micromort Concept and its Applicability to Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Risk Assessment”

Thank you for your insightful comments¹ on our article entitled "What's Your Micromort? A Patient-Oriented Analysis of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) Risk Assessment."² Activities such as drinking wine present risk in a J-shaped curve, in part because wine consumption may occur along a spectrum from none to excess. Whereas moderate wine consumption, even alongside heavy alcohol consumption, demonstrates multiple health benefits.³ Although the activities demonstrated by Wilson occur along a spectrum as well, many may present as all or none events, such as riding a bicycle 10 miles, riding 300 miles in a car, or traveling 1000 miles in a jet.⁴ Despite his data being older, these events would not present in a J-shaped curve as riding less in a car will not impose health benefits, but will instead only decrease risk. Likewise, having breast implants is an all or nothing event. Therefore, one cannot have "less" of a breast augmentation in hopes of pursuing health benefits. For this reason, we believe using the micromort terminology is well founded and is a valuable tool for patient education on BIA-ALCL.