Ultrasound Versus MRI for Evaluation of Silicone Leakage from Silicone Breast Implants

Overview

Journal Heliyon

Specialty Social Sciences

Date 2024 Jul 18

PMID 39022001

Authors

Karlinde A Spit

Siham Azahaf

Christel J M de Blok

Katya M Duvivier

Oliver T Wiebenga

Prabath W B Nanayakkara

Affiliations

Soon will be listed here.

Abstract

Background: Implant ruptures and gel bleed are not uncommon among women with silicone breast implants. While magnetic resonance imaging (MRI) is traditionally considered the gold standard diagnostic modality, recent studies suggest ultrasound might be an acceptable alternative. This study compares the efficacy of ultrasound and MRI in assessing implant integrity.

Methods: Women with silicone breast implants underwent a breast and axillary ultrasound and MRI on the same day. All tests were assessed by experienced radiologists. The accuracy, sensitivity, and specificity of ultrasound and MRI for implant rupture detection and silicone depositions in axillary lymph nodes were evaluated.

Findings: A total of 104 women participated in the study. The accuracy, sensitivity, and specificity of ultrasound for detecting implant ruptures compared to MRI were 96 %, 95 %, and 96 %, respectively. MRI demonstrated significantly lower sensitivity (44 %) for detecting silicone depositions in axillary lymph nodes compared to ultrasound. A significant association was observed between the presence of enlarged axillary lymph nodes and/or axillary pain and the detection of silicone depositions in axillary lymph nodes on ultrasound (χ (1, = 104) = 5·1, = 0·024). Six women exhibited silicone depositions in axillary lymph nodes despite having intact first-pair implants, indicative of gel bleed.

Interpretation: Ultrasound is nearly as effective as MRI for detecting breast implant ruptures and is superior for detecting silicone depositions in axillary lymph nodes. We therefore recommend initiating radiological examination in women with breast implants with a breast and axillary ultrasound, proceeding to MRI only if the ultrasound is inconclusive. The prevalence of gel bleed is understudied and its potential adverse health effects might be underestimated. Further research is needed to explore its potential association with development of systemic symptoms.

Citing Articles

Prevalence of Silicone Lymphadenopathy in Women with Breast Implants: A single-center retrospective study.

Berben J, Heuts E, van Nijnatten T, van der Hulst R JPRAS Open. 2025; 44:1-10.

PMID: 40078271 PMC: 11894321. DOI: 10.1016/j.jpra.2025.01.016.

Increased FGF-19 levels following explantation in women with breast implant illness.

Azahaf S, Spit K, de Blok C, Nanayakkara P Sci Rep. 2025; 15(1):3652.

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The Role of Positron Emission Tomography Imaging in Breast Implant Illness.

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PMID: 39823024 PMC: 11737493. DOI: 10.1097/GOX.0000000000006458.

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