DIAGNOSIS OF SILICONE GEL BREAST IMPLANT RUPTURE BY ULTRASONOGRAPHY

To prospectively evaluate the efficacy of ultrasonography in the diagn osis of ruptured silicone gel breast implants, 98 patients (192 implan ts) underwent preoperative breast ultrasonography prior to silicone ge l br east implant removal. The prevalence of implant rupture confirmed at surgery in this group of patients was 62 of the 192 implants (32 p ercent). Of the 60 implants diagnosed as ruptured by ultrasonography, 46 were confirmed as having visible defects at surgery (true positive) for a positive predictive value of 77 percent. Of the 132 implants di agnosed as intact by ultrasonography, 116 were confirmed as intact at surgery (true negative) for a negative predictive value of 88 percent. Overall, the sensitivity of ultrasonography for implant rupture was 7 4 percent, and the specificity was 89 percent. These findings demonstr ate that ultrasonography is an effective imaging modality for the diag nosis of silicone gel breast implant rupture. Compared with mammograph y, ultrasonography appears to offer superior sensitivity and specifici ty without radiation exposure or discomfort. Although magnetic resonan ce imaging has shown considerable promise in the diagnosis of implant rupture, ultrasonography provides comparable sensitivity at a fraction of MRI's cost.