VALUE OF CONTRAST-ENHANCED MRI OF BREAST AFTER SILICONE IMPLANT

Early recognition of recurrence and work-up of clinically indeterminat e lesions may be impaired after reconstruction with silicone implants due to superimposition of the implant or to scarring. This study was u ndertaken to evaluate the use of contrast-enhanced MRI in patients wit h silicone implant after breast cancer. Contrast-enhanded MRI was offe red to 169 patients. Comparative two-to-three-view mammography was als o performed in 169 patients, as well as comparative sonography in 144 patients. Conventional imaging and clinical examination detected only 8/13 recurrences, whereas 12/13 were detected by MRI. One recurrence h ad been visible as a strongly enhancing 2-mm dot in a previous examina tion (2 years before), but was not called. It was therefore counted as false negative. In addition, multicentricity was detected by MRI alon e in two of three cases. MRI correctly diagnosed scar tissue in all ca ses with indeterminate findings. However, due to false-positive calls caused by enhancing granulomas specificity could not be improved. Cont rast-enhanded MRI allowed decisive additional information in our study group and improved the sensitivity significantly (concerning all diag noses). Contrast-enhanded MRI is recommended in patients with diagnost ic problems or high risk of recurrence after silicone implants.