Imaging findings of absorbable Vicryl mesh implanted after lumpectomy

Abstract

A implantação da tela de Vicryl após quadrantectomia, proposta pela primeira vez em 2003, é uma técnica simples, sendo menos dispendiosa do que outros biomateriais implantáveis. Entretanto, o acompanhamento pós-operatório pode ser difícil, uma vez que a tela implantada compromete a avaliação do parênquima mamário adjacente, tanto na mamografia quanto na ultrassonografia. A ressonância magnética pode ser utilizada se houver achados duvidosos no exame físico, na mamografia ou na ultrassonografia. No entanto, existem poucos relatos na literatura sobre os aspectos de imagem da tela absorvível implantada na mama. As imagens apresentadas neste caso mostram a apresentação típica de um granuloma de corpo estranho associado à tela de Vicryl. Radiologistas e cirurgiões devem estar cientes desses aspectos de imagem para evitar diagnósticos incorretos e exames adicionais desnecessários. ABSTRACTThe Vicryl mesh implantation after lumpectomy, which was first proposed in 2003, is a simple technique, less expensive than other proposed implantable biomaterials. However, the postoperative follow-up may be difficult, since the implanted mesh impairs the evaluation of surrounding breast parenchyma at both mammography and ultrasound. Magnetic resonance imaging can be used as a problem-solving tool if there are equivocal findings at physical exam, mammography, or ultrasound. Nevertheless, there are only few reports in literature about the imaging aspects of implanted absorbable mesh in the breast. The images presented in this case show the typical presentation of a foreign body granuloma associated with the Vicryl mesh. Breast radiologists and surgeons should be aware of these imaging aspects to avoid misdiagnosis and unnecessary additional exams.

The 10-Year Experience with Volume Distribution Mastopexy: A Novel, Safe, and Efficient Method for Breast Rejuvenation

“…However, although visualization of the breast parenchyma may be impaired with ultrasound and mammography, magnetic resonance imaging can be used as a problem-solving tool. 20 Ultimately, a foreign body in the breast remains a risk factor for infection, 21 and only one case report exists of a chronic abscess in a patient who underwent mastopexy with a polypropylene mesh. 22 Eventually, fat grafting for further volume enhancement and projection can be considered as an adjunct tool in some patients, mainly to achieve upper pole fullness.…”

“…Our series did not incur any breast biopsies or interference with breast imaging, and no series of mastopexy with mesh has established such concerns. Nevertheless, Bitencourt et al indicate that breast imaging for patients with Vicryl mesh is reported to exhibit a “typical foreign body granulomatous reaction,” 20 and that “breast radiologists and surgeons should be aware of these imaging aspects to avoid misdiagnosis and unnecessary additional exams.” 20 As for the ProGrip mesh, none of our patients who underwent volume distribution mastopexy with ProGrip mesh had reported any problem with visualization of their breast imaging (Fig. 2, below ).…”