Imaging findings of mammary and systemic silicone deposition secondary to breast implants

Abstract

In patients with silicone breast implants, implant rupture can occur, which can be intra- or extracapsular. Following implant rupture, silicone can travel through the lymphatic system into regional and distant lymph nodes. The purpose of this pictorial essay is to present findings of silicone implant rupture with intramammary and systemic silicone deposition as seen on dual energy CT, ultrasound, mammogram, PET/CT and MRI. We include imaging findings of silicone deposition in the breast in cases of intra- and extracapsular rupture. We also present silicone deposition in mediastinal, axillary, and internal mammary lymph nodes, as well as in the liver and spleen. To our knowledge, deposition of silicone in the liver and spleen has not been previously demonstrated on cross-sectional imaging. While all imaging modalities were able to detect silicone in the spleen, ultrasound appeared to be more sensitive than dual energy CT or MRI for detection of silicone deposition in the liver.

The Inflammatory Effects of Breast Implant Particulate Shedding: Comparison With Orthopedic Implants

“…It is well established that when ruptured, BI silicone debris will be disseminated systemically and cause local and systemic pathologies, such as granulomas. 52-54 This was evidenced dramatically in case reports such as one of systemically developed granulomas with histologically identified silicone debris and secondary morbidities such as vision loss. This pathology was caused by a ruptured BI combined with cosmetic silicone injections, which disseminated to remote locations such as the patient’s arms.…”

Late migration of silicon as a complication to breast transplant rupture: Case report and literature review

“…Since then, silicone implants have been developed in five generations, improving the quality of the breast implants to minimize the complications such as gel bleeding, rupture and cosmetic appearance [1] . In general, the prevalence of rupture increases with implant age, and the median life expectancy of silicone implants is 10–16 years [2] , [3] .…”

Biopsy Results Are Not Sufficient to Exclude Breast Implant–associated Anaplastic Large Cell Lymphoma: A Case Mistaken for Disseminated Silicosis

“…Illicit injection of silicone, which is banned by the FDA, is associated with catastrophic complications, including blindness, pulmonary embolism, and death. 7 Silicone breast implants were first invented by Cronin in the 1960s, and first- and second-generation implants were used until the FDA moratorium in 1992. 7 These initial generations used lightly cross-linked silicone and extracapsular leaking of silicone, termed “silicone bleeding,” which was an uncommon complication.…”

“… 7 Silicone breast implants were first invented by Cronin in the 1960s, and first- and second-generation implants were used until the FDA moratorium in 1992. 7 These initial generations used lightly cross-linked silicone and extracapsular leaking of silicone, termed “silicone bleeding,” which was an uncommon complication. 7 , 8 This silicone differs from the highly cross-linked cohesive silicone in third generation that garnered FDA approval in 2006 and is not prone to the same complication.…”

“… 7 These initial generations used lightly cross-linked silicone and extracapsular leaking of silicone, termed “silicone bleeding,” which was an uncommon complication. 7 , 8 This silicone differs from the highly cross-linked cohesive silicone in third generation that garnered FDA approval in 2006 and is not prone to the same complication. 8 In this case, the patient’s breast implants were approximately 10 years old and would have been third or subsequent generation.…”