MRI Breast Without IV Contrast MRI without IV contrast may identify a fluid collection associated with the implant but is of limited value in the detection of an associated mass. US provides an easier means to assess for effusion and has the added benefit of guiding aspiration for cytologic diagnosis. MRI breast without IV contrast may serve to evaluate for the presence of implant rupture when there is a silicone implant [13]. US Breast Initial workup may include US evaluation for fluid collection, breast masses, and enlarged regional lymph nodes (axillary, supraclavicular, and internal mammary) [8,11,43]. Other symptoms can include breast enlargement, skin rash, capsular contracture, and lymphadenopathy [8]. Early recognition is critical, however, as diagnosis can often Breast Implant Evaluation be made from cytological analysis of the fluid, and patients with disease limited to the implant capsule have a much better prognosis than those with an associated mass or systemic disease [8,11,44-48]. US will frequently identify a fluid collection or mass if present and provides image guidance for diagnostic aspiration of the fluid for cytology or core biopsy of a mass lesion [4]. In cases in which a mass (or masses) is present, it most commonly appears as an oval, hypoechoic, and well-circumscribed solid mass, without hypervascularity, although a complex-cystic mass has also been observed [13]. Adrada et al [11] reported an 84% sensitivity for detection of effusion and a 46% sensitivity for detection of a mass, with a corresponding specificity of 75% and 100%, respectively. Periprosthetic effusions should undergo fine needle aspiration, and any suspicious mass should undergo tissue biopsy; specimens should be sent for cytology [4,8]. Ideally, a minimum of 50 mL of fluid should be sent to the laboratory with a specific request to evaluate for BIA-ALCL [8].
Breast Implant Evaluation. MRI Breast Without IV Contrast MRI without IV contrast may identify a fluid collection associated with the implant but is of limited value in the detection of an associated mass. US provides an easier means to assess for effusion and has the added benefit of guiding aspiration for cytologic diagnosis. MRI breast without IV contrast may serve to evaluate for the presence of implant rupture when there is a silicone implant [13]. US Breast Initial workup may include US evaluation for fluid collection, breast masses, and enlarged regional lymph nodes (axillary, supraclavicular, and internal mammary) [8,11,43]. Other symptoms can include breast enlargement, skin rash, capsular contracture, and lymphadenopathy [8]. Early recognition is critical, however, as diagnosis can often Breast Implant Evaluation be made from cytological analysis of the fluid, and patients with disease limited to the implant capsule have a much better prognosis than those with an associated mass or systemic disease [8,11,44-48]. US will frequently identify a fluid collection or mass if present and provides image guidance for diagnostic aspiration of the fluid for cytology or core biopsy of a mass lesion [4]. In cases in which a mass (or masses) is present, it most commonly appears as an oval, hypoechoic, and well-circumscribed solid mass, without hypervascularity, although a complex-cystic mass has also been observed [13]. Adrada et al [11] reported an 84% sensitivity for detection of effusion and a 46% sensitivity for detection of a mass, with a corresponding specificity of 75% and 100%, respectively. Periprosthetic effusions should undergo fine needle aspiration, and any suspicious mass should undergo tissue biopsy; specimens should be sent for cytology [4,8]. Ideally, a minimum of 50 mL of fluid should be sent to the laboratory with a specific request to evaluate for BIA-ALCL [8].