eMedicine Specialties > Radiology > Breast

Breast, Implant Rupture: Follow-up

Author: Richard L Hallett, MD, Adjunct Clinical Assistant Professor, Department of Radiology, Stanford University Medical Center
Contributor Information and Disclosures

Updated: Mar 20, 2008

Intervention

Medicolegal Pitfalls

  • Failure to accurately diagnose SGBI rupture could lead to increased legal liability should there be perceived physical or psychological injury from the decision—based on findings from relevant imaging examinations—not to explant the prosthesis. Such injuries could legally be found to be partially or wholly attributable to an incomplete imaging examination; potential causes include inappropriate or insufficient MR pulse sequences for diagnosis, incomplete ultrasonographic evaluation of the entire implant, or mistaken evaluation of the opposite-sided implant. 
  • Errors of omission involving significant imaging-related findings that could alter proposed therapy, such as the linguine, snowstorm, or echodense noise signs or extracapsular free silicone, would also increase potential legal liability. Therefore, a thorough and appropriate examination should be performed in all cases, and development of modality-specific protocols is encouraged.

Special Concerns

  • Management of ruptured SGBIs typically involves explantation of the prosthesis, with or without reconstruction. Reasons for removal include the potential for silicone migration with subsequent inflammatory reaction; the development of adverse local symptoms in the patient, including pain, deformity, and granuloma formation, is also considered a cause for removal. Removal of SGBIs in patients who have symptoms of connective tissue disease, fibromyalgia, or chronic fatigue syndrome is advocated as well.
  • Screening for SGBI rupture in asymptomatic women remains controversial. Some authors advocate mass screening with MRI, while others advocate prophylactic removal at or around 8-10 years after implantation. Still others advocate no removal unless the patient is symptomatic and has imaging and clinical evidence of rupture.
 


More on Breast, Implant Rupture

Overview: Breast, Implant Rupture
Imaging: Breast, Implant Rupture
Follow-up: Breast, Implant Rupture
Multimedia: Breast, Implant Rupture
References
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References

  1. Cunningham B. The Mentor study on Contour Profile Gel Silicone MemoryGel breast implants. Plast Reconstr Surg. Dec 2007;120(7 Suppl 1):33S-39S. [Medline].

  2. Spear SL, Murphy DK, Slicton A, et al. Inamed silicone breast implant core study results at 6 years. Plast Reconstr Surg. Dec 2007;120(7 Suppl 1):8S-16S; discussion 17S-18S. [Medline].

  3. McLaughlin JK, Lipworth L, Murphy DK, et al. The safety of silicone gel-filled breast implants: a review of the epidemiologic evidence. Ann Plast Surg. Nov 2007;59(5):569-80. [Medline].

  4. Hölmich LR, Lipworth L, McLaughlin JK, Friis S. Breast implant rupture and connective tissue disease: a review of the literature. Plast Reconstr Surg. Dec 2007;120(7 Suppl 1):62S-69S. Review. [Medline].

  5. Goodman CM, Cohen V, Thornby J, et al. The life span of silicone gel breast implants and a comparison of mammography, ultrasonography, and magnetic resonance imaging in detecting implant rupture: a meta-analysis. Ann Plast Surg. Dec 1998;41(6):577-85; discussion 585-6. [Medline].

  6. Brown SL, Middleton MS, Berg WA, et al. Prevalence of rupture of silicone gel breast implants revealed on MR imaging in a population of women in Birmingham, Alabama. AJR Am J Roentgenol. Oct 2000;175(4):1057-64. [Medline]. [Full Text].

  7. Brown SL, Parmentier CM, Woo EK, et al. Silicone gel breast implant adverse event reports to the Food and Drug Administration, 1984-1995. Public Health Rep. Nov-Dec 1998;113(6):535-43. [Medline]. [Full Text].

  8. Noone RB. A review of the possible health implications of silicone breast implants. Cancer. May 1 1997;79(9):1747-56. [Medline].

  9. Silverman BG, Brown SL, Bright RA, et al. Reported complications of silicone gel breast implants: an epidemiologic review. Ann Intern Med. Apr 15 1996;124(8):744-56. [Medline]. [Full Text].

  10. Caskey CI, Berg WA, Hamper UM, et al. Imaging spectrum of extracapsular silicone: correlation of US, MR imaging, mammographic, and histopathologic findings. Radiographics. Oct 1999;19 Spec No:S39-51; quiz S261-2. [Medline].

  11. Middleton MS, McNamara MP Jr. Breast implant classification with MR imaging correlation: (CME available on RSNA link). Radiographics. May 2000;20(3):E1. [Medline]. [Full Text].

  12. Gorczyca DP, Gorczyca SM, Gorczyca KL. The diagnosis of silicone breast implant rupture. Plast Reconstr Surg. Dec 2007;120(7 Suppl 1):49S-61S. Review. [Medline].

  13. Morgan DE, Kenney PJ, Meeks MC, et al. MR imaging of breast implants and their complications. AJR Am J Roentgenol. Nov 1996;167(5):1271-5. [Medline].

  14. Orel SG. MR imaging of the breast. Radiol Clin North Am. Jul 2000;38(4):899-913. [Medline].

  15. DeBruhl ND, Gorcyzca DP, Bassett LW. The Augmented Breast. In: Bassett LW, Jackson VP, Eds. Diagnosis of Diseases of the Breast. Philadelphia, Pa: WB Saunders; 1997:563-79.

  16. Palmon LU, Foshager MC, Parantainen H, et al. Ruptured or intact: what can linear echoes within silicone breast implants tell us?. AJR Am J Roentgenol. Jun 1997;168(6):1595-8. [Medline].

  17. Venta LA, Salomon CG, Flisak ME, et al. Sonographic signs of breast implant rupture. AJR Am J Roentgenol. Jun 1996;166(6):1413-9. [Medline].

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Further Reading

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Keywords

imaging of silicone gel breast implant rupture, SGBI

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Contributor Information and Disclosures

Author

Richard L Hallett, MD, Adjunct Clinical Assistant Professor, Department of Radiology, Stanford University Medical Center
Richard L Hallett, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, North American Society for Cardiac Imaging, Radiological Society of North America, Society for Cardiovascular Magnetic Resonance, and Society of Interventional Radiology
Disclosure: Nothing to disclose.

Medical Editor

John M Lewin, MD, Associate Clinical Professor, Department of Preventative Medicine and Biometrics, Director of Teleradiology, Co-director of Breast Imaging Section, Director of Breast Imaging Research, Department of Radiology, University of Colorado Health Sciences Center; Consulting Radiologist, Diversified Radiology of Colorado
John M Lewin, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Radiological Society of North America, and Society of Breast Imaging
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Edward Azavedo, MD, PhD, Director of Clinical Breast Imaging Services, Associate Professor, Department of Radiology, Karolinska University Hospital, Sweden
Edward Azavedo, MD, PhD is a member of the following medical societies: Swedish Medical Association and Swedish Society of Medicine
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Staff, Department of Radiology, Virginia Mason Medical Center
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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