RADIOGRAPHIC DIAGNOSIS OF BREAST IMPLANT RUPTURE - CURRENT STATUS ANDCOMPARISON OF TECHNIQUES

Rupture of a breast implant is a recognized complication of augmentati on mammaplasty and reconstructive breast surgery. Due to concerns over the extravasation of silicone gel within adjacent tissue and distant body sites, considerable attention has been given to the radiographic detection of mammary implant rupture. A metaanalysis comparing the acc uracy of various currently available imaging modalities tvas conducted and an algorithm suggested to guide clinicians in the detection of br east implant rupture. Advantages and limitations of mammography, xerom ammography, ultrasonography, MRI, and CT are outlined as well as some of the most specific radiographic signs of each with illustrative exam ples from patients evaluated at our institution. Results of our retros pective analysis corroborated by a review of the most recent literatur e reveal that mammography supplemented with ultrasonography constitute s the most cost-effective initial study, followed by MRI if these are equivocal. MRI is the most sensitive and specific study to evaluate br east implant rupture.