Silicone within low axillary nodes may be seen on mammography and DBT. When mammography is performed, axillary US is complementary and may be performed at the same time. MRI Breast Without and With IV Contrast There is no relevant literature to support MRI without and with IV contrast in this setting as the initial imaging study in this setting. However, it is needed if biopsy shows axillary metastatic disease from a mammographically and sonographically occult primary breast carcinoma. MRI Breast Without IV Contrast MRI without IV contrast is of limited value in evaluation of unexplained axillary adenopathy in patients 30 to 39 years of age because its primary function would be to identify silicone in the lymph nodes as an explanation for the adenopathy. MRI Breast Without and With IV Contrast MRI without and with IV contrast may not be ideal in this setting. However, it is needed if biopsy shows axillary metastatic disease from a mammographically and sonographically occult primary breast carcinoma. Breast Implant Evaluation Variant 13: Adult of any age. Female or transfeminine. Suspected breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) (delayed seroma, swelling, mass, pain, but no erythema, warmth, or skin changes that would raise concern for inflammatory breast cancer or mastitis). Breast implant of any type. Initial imaging. Digital Breast Tomosynthesis Diagnostic If the patient is >40 years of age, DBT may be considered. DBT has a low sensitivity and specificity for BIA-ALCL, but it may be used to assess for any potential mimics or masses and other diagnoses including in situ and invasive primary breast malignancy [11,40]. In cases of BIA-ALCL, the capsule may be thickened and the membrane contour may be disrupted [11]. In general, DBT findings include nonspecific capsular thickening, circumferential asymmetry around the implant, or irregular mass [13]. DBT may detect a change in implant appearance related to a new fluid collection or an associated mass.
Breast Implant Evaluation. Silicone within low axillary nodes may be seen on mammography and DBT. When mammography is performed, axillary US is complementary and may be performed at the same time. MRI Breast Without and With IV Contrast There is no relevant literature to support MRI without and with IV contrast in this setting as the initial imaging study in this setting. However, it is needed if biopsy shows axillary metastatic disease from a mammographically and sonographically occult primary breast carcinoma. MRI Breast Without IV Contrast MRI without IV contrast is of limited value in evaluation of unexplained axillary adenopathy in patients 30 to 39 years of age because its primary function would be to identify silicone in the lymph nodes as an explanation for the adenopathy. MRI Breast Without and With IV Contrast MRI without and with IV contrast may not be ideal in this setting. However, it is needed if biopsy shows axillary metastatic disease from a mammographically and sonographically occult primary breast carcinoma. Breast Implant Evaluation Variant 13: Adult of any age. Female or transfeminine. Suspected breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) (delayed seroma, swelling, mass, pain, but no erythema, warmth, or skin changes that would raise concern for inflammatory breast cancer or mastitis). Breast implant of any type. Initial imaging. Digital Breast Tomosynthesis Diagnostic If the patient is >40 years of age, DBT may be considered. DBT has a low sensitivity and specificity for BIA-ALCL, but it may be used to assess for any potential mimics or masses and other diagnoses including in situ and invasive primary breast malignancy [11,40]. In cases of BIA-ALCL, the capsule may be thickened and the membrane contour may be disrupted [11]. In general, DBT findings include nonspecific capsular thickening, circumferential asymmetry around the implant, or irregular mass [13]. DBT may detect a change in implant appearance related to a new fluid collection or an associated mass.