A 70 y/o woman presents for her screening mammogram

 

Images

Doctor's Information

Name : Maryam
Family : Noori
Affiliation :Teb Azma Imaging Center,Ghom,Iran
Academic Degree : Radiologist
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : ------------------

 

Case Section

Breast Imaging

 

Patient's Information

Gender : Female
Age : 70

 

Clinical Summary

The woman has had breast augmentation for over 20 years.

 

Imaging Findings

The patient’s mammogram (bilateral MLO & CC views) demonstrates the right subglandular implant has ruptured and completely collapsed also the left implant is deformed & the clips mark the location of the previous surgery.

 

Differential Diagnosis

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Final Diagnosis

collapsed both breasts implants.

 

Discussion (Related Text)

When an implant is inserted, a fibrous capsule develops around the implant elastomeric shell. There are two types of implant failure: intracapsular and extracapsular. Intracapsular failure involves rupture of the implant elastomeric shell without rupture of the surrounding fibrous capsule. With intracapsular rupture, the liquid contents of the implant are contained within the fibrous capsule. Extracapsular failure is when both the implant elastomeric shell and the fibrous capsule have been ruptured. As a result of this type of rupture, the internal contents of the implant (silicone or water) are extruded outside the capsule into the surrounding tissues. Saline implants have a higher rate of leakage and a less natural feel than silicone implants. The advantages of saline are that they have a lower reported incidence of contracture and that leakage from the implant is undesirable but harmless. Sonography is better than mammography but not as accurate as MRl in identifying implant rupture. Mammographic findings: Calcifications (Ca++) in fibrous capsule in - 25%: Parallel to implant surface, sheet-like dystrophic & more common in subglandular than subpectoral. Implant becomes more rounded with contracture. Shell may be wrinkled, especially if underfilled. Dense, oval or round masses due to extracapsular silicone: Implies rupture of current implant unless retained from prior implant rupture & may develop rim Ca++. Parenchyma: Implant obscures a portion of breast despite implant-displaced views.

 

References

Breast Imaging A Correlative Atlas, Beverly Hashimoto & Donald Bauermeister. Diagnostic Imaging Breast. Berg & Birdwell et al.

 

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