Role of Different Radiological Modalities in Assessment of Breast Implants

Abstract

Summary and Conclusion B reast augmentation is a common cosmetic procedure, and many women who have undergone augmentation present for mammographic screening. A wide variety of breast implants are available on the market and are broadly categorized by lumen number, filler type, and surface contour. Breast implants can be surgically introduced using a variety of different approaches and are most commonly positioned either deep to the glandular tissue or deep to thepectoralis major muscle. Although silicone and saline implants are the most common form of augmentation seen on imaging, there is tremendous variation in surgical techniques and materials throughout the world. Therefore, less common forms of augmentation, such as free silicone injection, polyacrylamide gel, and autologous fat augmentation, may also be seen when evaluating women in a screening or diagnostic setting. Familiarity with all forms of augmentation is important to maximize cancer detection and manage complications related to augmentation procedures. Early postoperative complications of breast augmentation include hematoma and infection. Late postoperative complications include capsular contracture, silicone granuloma formation, and implant rupture. Rupture is now recognized as an important and common complication of breast implants. Magnetic resonance (MR) imaging is the most accurate method for evaluating implant integrity. MRI requires modern dedicated breast-imaging coils, and necessitates a thorough knowledge of implants and of potential diagnostic pitfalls. Detailed information regarding the type of implant and surgical technique, the time interval since surgery and any radiotherapy should be available before the examination is interpreted. The appearance of breast implants at mammography, ultrasound and MRI are variable. Knowledge of the variety of breast implant types will help reduce misdiagnoses by providing imagers with better understanding of the expected appearances of breast implants. This awareness with implant classification allow stratification of data for studying incidence, prevalence, and risk factors for and causes of implant failure, as well as permitting better correlation with patient symptoms and surgical outcome.