Silicone gel breast implant rupture diagnosed by magnetic resonance imaging

Abstract

CASE REPORT A 50­year­old female was referred to the X­ray department with a complaints of slowly growing mass in the lower outer quadrant of her left breast and a sudden strong pain with change in the breast size and shape. Her past medical history reported an augmentation mammoplasty silicone breast implant 15 years ago. Physical examination showed a localized swelling in the lower outer quadrant of the left breast, with a presence of palpable mass given a high significant of breast implant rupture. Rest of physical examination were normal. A non­contrast magnetic resonance imaging (MRI) revealed a left side breast implant rupture (Figure 1). DISCUSSION Breast implants composed of silicone gel enveloped in a silicone rubber elastomer were introduced in 1963. The frequency of rupture of silicone­gel­filled breast prostheses is unknown, as are the associated health effects [1]. Brown SL et al. reported that on MRI, the prevalence of silicone gel implant rupture in a population­based study of 344 women in Birmingham, Alabama, was 55% and that 22% of ruptured implants showed extracapsular spread of silicon [2]. In 2003, Lisbet et al. reported 33 definite ruptures (10%) and 23 possible ruptures (7%) during a 2­year period. The overall rupture incidence rate for definite ruptures was 5.3 ruptures/100 implants per year [3]. Rupture of silicone breast implants is caused by stress on the implant at the time of surgical placement, trauma, defects in manufacture, long­term repetitive CLINICAL IMAGES OPEN ACCESS