Prevalence of rupture of silicone gel breast implants revealed on MR imaging in a population of women in Birmingham, Alabama

OBJECTIVE. Silicone gel breast implants have been reported to rupture, but the prevalence of implant rupture in an unreferred population of women is n ot known. The objective of this study was to assess the prevalence of impla nt rupture and the presence of extracapsular silicone gel in an unreferred population of women without regard to the absence or presence of any local or systemic symptoms. SUBJECTS AND METHODS. Women identified as part of a National Cancer Institu te cohort study on breast implants, living in the Birmingham, AL, area were invited to undergo MR imaging of their current silicone gel breast implant s at the Kirl;lin Clinic at the University of Alabama at Birmingham. Three radiologists independently examined and rated all MR images for signs of im plant rupture and extracapsular silicone. RESULTS. A total of 344 women with silicone gel boast implants underwent MR imaging. Breast implant rupture was reported by at least two of three radi ologists for 378 (55.0%) of the 687 implants in this study. Another 50 impl ants (7.2%) were rated as indeterminate (suspicious) for rupture. A majorit y of women in this study, 265 (77.0%) of 344, had at least one breast impla nt that was rated as ruptured or indeterminate. Radiologists also agreed th at silicone gel could be seen outside the fibrous capsule that forms around the: implant in 85 (12.4%) of the 687 implants affecting 73 women (21.2%). Factors that affected implant rupture were implant age and location (submu scular or subglandular). The median implant age at rupture was estimated to be 10.8 years with a 95% confidence interval of 8.4-13.9 years. CONCLUSION. The prevalence of silent or occult silicone gel boast implant r upture is higher than was previously suspected. Most women in this study ha d MR imaging evidence of at least one ruptured silicone gel breast implant.