Mammogram, Ultrasound and MRI accuracy in detecting ruptured implants

Mammography

Mammography is a radiographic imaging technique  that has proven value in assessing changes in breast tissue such as breast cancer, and may detect free silicone within the breast gland. However it does not have strong value in assessing whether an implant is intact.

Ultrasound

Ultrasound (sonogram) does not utilize radiation, and also has value in determining changes in breast tissue such as solid or cystic masses. Mammograms and sonograms are often done together during a woman’s annual examination to monitor breast health. But sonograms also have value in assessing whether an implant is intact. It may indicate that an implant has leaked/ruptured within the scar capsule (intracapsular rupture), or whether the leak of silicone has gone outside of the scar capsule (extracapsular rupture). Insurance companies will typically cover the cost of ultrasound if the goal is to evaluate whether implants have leaked. If an ultrasound raises concern, the next step is to do further evaluation with MRI. However, even without MRI a woman may proceed with implant and capsule removal based on the ultrasound alone.

Magnetic resonance imaging (MRI)

Magnetic resonance imaging (MRI) is the most sensitive technique in the evaluation of breast tissue and implant integrity.  MRI with contrast is used for breast tissue evaluation, but noncontrast MRI is sufficient for evaluating implant integrity. Its sensitivity for rupture is between 80% and 90%, Insurance companies may not authorize this imaging study unless suspicion has been raised by previous mammogram or sonogram.

It is important to note that Dr. Feingold has found unsuspected implant rupture at the time of capsulectomy even when both mammograms and sonograms are read as normal.

 

 

 

 

 

 

 

 

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