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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
- Saline implants are silicone elastomer bags (shell) filled with saline
- Most have valves/ports to inject saline when implants are placed
- Optimize cosmetic appearance
- Some saline implants are prefilled
- Most have valves/ports to inject saline when implants are placed
- Expanders have port at skin, can be gradually inflated or deflated
- Most often used for reconstruction post mastectomy
- 50-100 cc instilled each week until desired size
- Tubing to port may be palpable, visible on imaging
- Not MR compatible
- Capsule = fibrous tissue body forms around implant
- Contracture = hardening of capsule around implant
- Implant-displaced (ID) views = Eklund maneuver = pushback views: Implant displaced posteriorly while obtaining mammogram of parenchyma
- Improves compression and image quality
- Do not fully include most posterior tissues; standard CC and MLO views also required
- Saline implants are silicone elastomer bags (shell) filled with saline
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Image-Guided Biopsy
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- de Boer M et al: Breast implants and the risk of anaplastic large-cell lymphoma in the breast. JAMA Oncol. ePub, 2018
- Expert Panel on Breast Imaging:. et al: ACR Appropriateness Criteria Breast Implant Evaluation. J Am Coll Radiol. 15(5S):S13-S25, 2018
- Sosin M et al: Breast cancer following augmentation mammaplasty: A case-control study. Plast Reconstr Surg. 141(4):833-840, 2018
- Dikmans RE et al: Two-stage implant-based breast reconstruction compared with immediate one-stage implant-based breast reconstruction augmented with an acellular dermal matrix: an open-label, phase 4, multicentre, randomised, controlled trial. Lancet Oncol. 18(2):251-258, 2017
- Kaartinen I et al: Breast implant-associated anaplastic large cell lymphoma - From diagnosis to treatment. Eur J Surg Oncol. 43(8):1385-1392, 2017
- Filiciani S et al: Cohort Study to Assess the Impact of Breast Implants on Breastfeeding. Plast Reconstr Surg. 138(6):1152-1159, 2016
- Headon H et al: Capsular contracture after breast augmentation: An update for clinical practice. Arch Plast Surg. 42(5):532-43, 2015
- Rupani A et al: Lymphomas Associated with Breast Implants: A Review of the Literature. Aesthet Surg J. 35(5):533-44, 2015
- Shah M et al: Magnetic resonance imaging of breast implants. Top Magn Reson Imaging. 23(6):345-53, 2014
- Lavigne E et al: Can breast implants hinder breast cancer survival? Womens Health (Lond). 9(5):419-20, 2013
- Lavigne E et al: Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies. BMJ. 346:f2399, 2013
- Swanson E: Prospective outcome study of 225 cases of breast augmentation. Plast Reconstr Surg. 131(5):1158-66, 2013
- Lavigne E et al: Do breast implants adversely affect prognosis among those subsequently diagnosed with breast cancer? Findings from an extended follow-up of a Canadian cohort. Cancer Epidemiol Biomarkers Prev. 21(10):1868-76, 2012
- Handel N et al: A long-term study of outcomes, complications, and patient satisfaction with breast implants. Plast Reconstr Surg. 117(3):757-67; discussion 768-72, 2006
- Brown SL et al: Breast implant adverse events during mammography: reports to the Food and Drug Administration. J Womens Health (Larchmt). 13(4):371-8; discussion 379-80, 2004
- Miglioretti DL et al: Effect of breast augmentation on the accuracy of mammography and cancer characteristics. JAMA. 291(4):442-50, 2004
- Cunningham BL et al: Saline-filled breast implant safety and efficacy: a multicenter retrospective review. Plast Reconstr Surg. 105(6):2143-9; discussion 2150-1, 2000
- Rohrich RJ: The FDA approves saline-filled breast implants: what does this mean for our patients? Plast Reconstr Surg. 106(4):903-5, 2000
- Gutowski KA et al: Saline-filled breast implants: a Plastic Surgery Educational Foundation multicenter outcomes study. Plast Reconstr Surg. 100(4):1019-27, 1997
- Strom SS et al: Cosmetic saline breast implants: a survey of satisfaction, breast-feeding experience, cancer screening, and health. Plast Reconstr Surg. 100(6):1553-7, 1997
- Ahn CY et al: Clinical significance of intracapsular fluid in patients' breast implants. Ann Plast Surg. 35(5):455-7, 1995
- Handel N et al: Factors affecting mammographic visualization of the breast after augmentation mammaplasty. JAMA. 268(14):1913-7, 1992
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
- Saline implants are silicone elastomer bags (shell) filled with saline
- Most have valves/ports to inject saline when implants are placed
- Optimize cosmetic appearance
- Some saline implants are prefilled
- Most have valves/ports to inject saline when implants are placed
- Expanders have port at skin, can be gradually inflated or deflated
- Most often used for reconstruction post mastectomy
- 50-100 cc instilled each week until desired size
- Tubing to port may be palpable, visible on imaging
- Not MR compatible
- Capsule = fibrous tissue body forms around implant
- Contracture = hardening of capsule around implant
- Implant-displaced (ID) views = Eklund maneuver = pushback views: Implant displaced posteriorly while obtaining mammogram of parenchyma
- Improves compression and image quality
- Do not fully include most posterior tissues; standard CC and MLO views also required
- Saline implants are silicone elastomer bags (shell) filled with saline
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Image-Guided Biopsy
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
- de Boer M et al: Breast implants and the risk of anaplastic large-cell lymphoma in the breast. JAMA Oncol. ePub, 2018
- Expert Panel on Breast Imaging:. et al: ACR Appropriateness Criteria Breast Implant Evaluation. J Am Coll Radiol. 15(5S):S13-S25, 2018
- Sosin M et al: Breast cancer following augmentation mammaplasty: A case-control study. Plast Reconstr Surg. 141(4):833-840, 2018
- Dikmans RE et al: Two-stage implant-based breast reconstruction compared with immediate one-stage implant-based breast reconstruction augmented with an acellular dermal matrix: an open-label, phase 4, multicentre, randomised, controlled trial. Lancet Oncol. 18(2):251-258, 2017
- Kaartinen I et al: Breast implant-associated anaplastic large cell lymphoma - From diagnosis to treatment. Eur J Surg Oncol. 43(8):1385-1392, 2017
- Filiciani S et al: Cohort Study to Assess the Impact of Breast Implants on Breastfeeding. Plast Reconstr Surg. 138(6):1152-1159, 2016
- Headon H et al: Capsular contracture after breast augmentation: An update for clinical practice. Arch Plast Surg. 42(5):532-43, 2015
- Rupani A et al: Lymphomas Associated with Breast Implants: A Review of the Literature. Aesthet Surg J. 35(5):533-44, 2015
- Shah M et al: Magnetic resonance imaging of breast implants. Top Magn Reson Imaging. 23(6):345-53, 2014
- Lavigne E et al: Can breast implants hinder breast cancer survival? Womens Health (Lond). 9(5):419-20, 2013
- Lavigne E et al: Breast cancer detection and survival among women with cosmetic breast implants: systematic review and meta-analysis of observational studies. BMJ. 346:f2399, 2013
- Swanson E: Prospective outcome study of 225 cases of breast augmentation. Plast Reconstr Surg. 131(5):1158-66, 2013
- Lavigne E et al: Do breast implants adversely affect prognosis among those subsequently diagnosed with breast cancer? Findings from an extended follow-up of a Canadian cohort. Cancer Epidemiol Biomarkers Prev. 21(10):1868-76, 2012
- Handel N et al: A long-term study of outcomes, complications, and patient satisfaction with breast implants. Plast Reconstr Surg. 117(3):757-67; discussion 768-72, 2006
- Brown SL et al: Breast implant adverse events during mammography: reports to the Food and Drug Administration. J Womens Health (Larchmt). 13(4):371-8; discussion 379-80, 2004
- Miglioretti DL et al: Effect of breast augmentation on the accuracy of mammography and cancer characteristics. JAMA. 291(4):442-50, 2004
- Cunningham BL et al: Saline-filled breast implant safety and efficacy: a multicenter retrospective review. Plast Reconstr Surg. 105(6):2143-9; discussion 2150-1, 2000
- Rohrich RJ: The FDA approves saline-filled breast implants: what does this mean for our patients? Plast Reconstr Surg. 106(4):903-5, 2000
- Gutowski KA et al: Saline-filled breast implants: a Plastic Surgery Educational Foundation multicenter outcomes study. Plast Reconstr Surg. 100(4):1019-27, 1997
- Strom SS et al: Cosmetic saline breast implants: a survey of satisfaction, breast-feeding experience, cancer screening, and health. Plast Reconstr Surg. 100(6):1553-7, 1997
- Ahn CY et al: Clinical significance of intracapsular fluid in patients' breast implants. Ann Plast Surg. 35(5):455-7, 1995
- Handel N et al: Factors affecting mammographic visualization of the breast after augmentation mammaplasty. JAMA. 268(14):1913-7, 1992
