Most women, particularly those who have had breast augmentation surgery, don’t know that MRIs are useful in the early detection of silicone implant rupture or leakage. Unlike leaked or ruptured saline implants, in which the implant immediately deflates, and the body reabsorbs the saline, silicone gel implant leaks can remain undetected in the breast for a long time.
The U.S. Food and Drug Administration (FDA), which regulates the manufacture and sale of breast implants, released updated guidelines in June 2011 regarding the use of MRI to screen for undetected (“silent”) silicone implant rupture or leakage. An MRI screening was recommended starting three years after the breast augmentation surgery and every two years after that. The guidelines can be found here, with the specifics on MRI screening starting on page 29.
A study from the April 2008 issue of the medical journal Plastic and Reconstructive Surgery questioned the reliability of MRI to detect silicone implant leakage. It attempted to weigh the benefits of regular MRI screenings for silicone implant patients against the disadvantages, such as patient anxiety, a high rate of false-positives, and possibly unnecessary surgery to remove implants that may not be defective.
Another study from the March 2011 issue of the same journal looked at a group of 21 previously published studies to determine if there was a consensus as to the accuracy of MRI compared to ultrasound in detecting silicone leakage or rupture in women who showed symptoms, as well as those who did not. The researchers found that MRI was 14 times more likely to detect a silicone rupture or leakage in women with symptoms than those without symptoms. There was no consensus about the accuracy of ultrasound in detecting silicone implant rupture or leaking in women with or without symptoms.
Mammograms & Breast Implants
According to the American Cancer Society, most older women are aware that breast cancer mammography screenings usually begin at age 40 and are recommended as an annual preventive measure. The argument is that screening detection of breast cancer allows for early detection and treatment. Women with implants may be concerned that the results of mammogram exams may be affected.
Unfortunately, the implants can obscure a full view of the breast, making it more difficult to detect possible breast cancer early. Also, there is a slight risk that the mammogram machine can damage the implants when it squeezes the breast to get the image. Magnetic resonance imaging (MRI), which is more sophisticated than mammography, can provide a way to screen patients with breast implants for the possibility of breast cancer.
Overall, the conclusion is that patients need to work with both their cosmetic surgeon and their regular general practitioner to determine the best course of action regarding screening for both breast cancer and possible silicone implant leak or rupture (mainly if there are no symptoms).
*The content in this blog is developed to spread the awareness towards plastic surgery. Our blog is not intended to serve as a replacement for an actual in-office consultation with Dr. Marin. As such, the information within this blog reflects the unique cases of our individual patients.