Distinguishing between fluid and solid tissue typically requires US. One meta-analysis [11] reported a sensitivity of 73% and a specificity of 50% for mammography in the detection of an abnormality. Mammography Diagnostic If the patient is >40 years of age, mammography may be considered. Mammography 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, diagnostic mammography findings include nonspecific capsular thickening, circumferential asymmetry around the implant, or irregular mass [13]. Diagnostic mammography may detect a change in implant appearance related to a new fluid collection or an associated mass. Distinguishing between fluid and solid tissue typically requires US. One meta-analysis [11] reported a sensitivity of 73% and a specificity of 50% for mammography in detection of an abnormality. MRI Breast Without and With IV Contrast MRI without and with IV contrast is the second imaging test of choice and may be needed when US yields indeterminate results [9,41,42]. MRI has reported sensitivity of 82% for the detection of effusion and 50% for detection of a mass, with corresponding specificities of 33% and 93%, respectively [11]. MRI breast can be considered if US is equivocal or nondiagnostic. MRI findings include peri-implant tissue edema and effusion, as well as peri-implant mass lesions, including small volume mass components not detected with US [41,42]. The principal MRI signs seen in the Rotili et al [41] study included liquid-serous effusion, peri-implant and capsule related masses, enhancement of the capsule, irregular thickness of the capsule, and subcutaneous nodules of local recurrence of ALCL after capsulectomy.
Breast Implant Evaluation. Distinguishing between fluid and solid tissue typically requires US. One meta-analysis [11] reported a sensitivity of 73% and a specificity of 50% for mammography in the detection of an abnormality. Mammography Diagnostic If the patient is >40 years of age, mammography may be considered. Mammography 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, diagnostic mammography findings include nonspecific capsular thickening, circumferential asymmetry around the implant, or irregular mass [13]. Diagnostic mammography may detect a change in implant appearance related to a new fluid collection or an associated mass. Distinguishing between fluid and solid tissue typically requires US. One meta-analysis [11] reported a sensitivity of 73% and a specificity of 50% for mammography in detection of an abnormality. MRI Breast Without and With IV Contrast MRI without and with IV contrast is the second imaging test of choice and may be needed when US yields indeterminate results [9,41,42]. MRI has reported sensitivity of 82% for the detection of effusion and 50% for detection of a mass, with corresponding specificities of 33% and 93%, respectively [11]. MRI breast can be considered if US is equivocal or nondiagnostic. MRI findings include peri-implant tissue edema and effusion, as well as peri-implant mass lesions, including small volume mass components not detected with US [41,42]. The principal MRI signs seen in the Rotili et al [41] study included liquid-serous effusion, peri-implant and capsule related masses, enhancement of the capsule, irregular thickness of the capsule, and subcutaneous nodules of local recurrence of ALCL after capsulectomy.