SILICONE IMPLANT RUPTURE DIAGNOSIS USING COMPUTED-TOMOGRAPHY - A CASE-REPORT AND EXPERIENCE WITH 22 SURGICALLY REMOVED IMPLANTS

Silicone elastomer shell rupture is a complication of silicone implant s. To date, the rate of implant rupture has not been well documented. Magnetic resonance imaging and sonography are noninvasive breast impla nt imaging modalities that have been shown to be useful in evaluating the integrity of implants. We present a case of rupture detection usin g a follow-up computed tomographic (CT) scan of a breast cancer patien t, which prompted us to use CT scans to evaluate explants of patients undergoing implant removal surgery. The purpose of the investigation w as to evaluate the effectiveness of CT scan in detecting rupture. CT s can was performed on 22 explants with intact capsules, for which 17 ru ptures were confirmed: 16 true-positive ruptures, 5 true-negative rupt ures, 0 false-positive ruptures, and 1 false-negative rupture were ide ntified. CT scan was shown to be highly sensitive and specific in rupt ure detection, comparable to magnetic resonance imaging. Although CT s cans are consistently reliable, patients are exposed to ionizing radia tion; therefore, it is not recommended for patients with augmentation mammoplasty. This study characterizes the appearance of implant ruptur e on CT scan, which may be useful in evaluating breast cancer patients reconstructed with silicone implants.