Imaging spectrum of extracapsular silicone: Correlation of US, MR imaging,mammographic, and histopathologic findings

The appearance of free silicone at mammography, ultrasonography (US), and m agnetic resonance (MR) imaging is variable. The classic appearance is On fa t-suppressed T1-weighted MR images or high signal intensity on water suppre ssed T2-weighted MR images. Mammography is a reliable, cost-effective, tive , and readily available means of demonstrating silicone. The major disadvan tage of US is that its accuracy depends on the capability of the operator t o recognize the abnormality. Although MR imaging outperforms US or mammogra phy in detection of implant rupture, it is not clear that MR imaging is sup erior in detection of free or residual silicone, The sequelae of noncontain ed silicone include granuloma formation, fibrosis, and migration. After ext rusion from an implant, silicone migrates primarily to local sites, such as the ipsilateral chest wall and axillary nodes. Migration of silicone into the axilla can involve the brachial plexus, resulting in neuropathy. Silico ne can also migrate into more distal regions, including the arm and subcuta neous tissues of the abdominal wall, Whatever the source, silicone in breas t tissue interferes with the interpretation of mammographic findings.