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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
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
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
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
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
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
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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