Both standard craniocaudal and mediolateral oblique and implant-displaced views should be obtained. Mammography can identify extracapsular silicone [20,29-31,35], which presents as high- density material outside the confines of the implant shell. In patients without prior explantation of silicone implants, this finding is diagnostic of extracapsular rupture. However, in patients who have had prior silicone implants, this may represent residual silicone rather than rupture of the new implants, and comparison with priors is critical. MRI Breast Without and With IV Contrast There is no relevant literature to support the use of MRI without and with IV contrast in the evaluation of symptomatic silicone implants. US Breast In symptomatic patients with silicone breast implants, an MRI is recommended by the FDA to evaluate for rupture [1]. However, US can identify extracapsular silicone. Extracapsular rupture is disruption of both the polymer and fibrous capsules with leak of silicone into the breast tissue. Rupture of silicone implants, however, may be asymptomatic, especially if the rupture is intracapsular (contained by the fibrous shell formed by the body around the implant). If the rupture is extracapsular, patients may present with palpable masses or changes in breast contour. Diagnosis of extracapsular rupture of silicone implants is often made with mammography and/or US, in which high- density silicone is identified outside the confines of the implant shell. The rate of implant ruptures increases with time, and most of them do not cause any clinical symptoms. Once an implant ruptures, free silicone can migrate. Most frequently, free silicone infiltrates the adjacent breast tissues and sometimes can mimic breast cancer. US can Breast Implant Evaluation Variant 10: Adult younger than 30 years of age. Female or transfeminine. Evaluation of unexplained axillary adenopathy. Silicone breast implants (current or prior). Initial imaging.
Breast Implant Evaluation. Both standard craniocaudal and mediolateral oblique and implant-displaced views should be obtained. Mammography can identify extracapsular silicone [20,29-31,35], which presents as high- density material outside the confines of the implant shell. In patients without prior explantation of silicone implants, this finding is diagnostic of extracapsular rupture. However, in patients who have had prior silicone implants, this may represent residual silicone rather than rupture of the new implants, and comparison with priors is critical. MRI Breast Without and With IV Contrast There is no relevant literature to support the use of MRI without and with IV contrast in the evaluation of symptomatic silicone implants. US Breast In symptomatic patients with silicone breast implants, an MRI is recommended by the FDA to evaluate for rupture [1]. However, US can identify extracapsular silicone. Extracapsular rupture is disruption of both the polymer and fibrous capsules with leak of silicone into the breast tissue. Rupture of silicone implants, however, may be asymptomatic, especially if the rupture is intracapsular (contained by the fibrous shell formed by the body around the implant). If the rupture is extracapsular, patients may present with palpable masses or changes in breast contour. Diagnosis of extracapsular rupture of silicone implants is often made with mammography and/or US, in which high- density silicone is identified outside the confines of the implant shell. The rate of implant ruptures increases with time, and most of them do not cause any clinical symptoms. Once an implant ruptures, free silicone can migrate. Most frequently, free silicone infiltrates the adjacent breast tissues and sometimes can mimic breast cancer. US can Breast Implant Evaluation Variant 10: Adult younger than 30 years of age. Female or transfeminine. Evaluation of unexplained axillary adenopathy. Silicone breast implants (current or prior). Initial imaging.