The efficacy of ultrasound, mammography and magnetic resonance imaging in detecting breast implant rupture: a retrospective study of 175 reconstructive and aesthetic sub-pectoral breast augmentation cases

Publication date: Available online 3 June 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Alessio Stivala, Kessara Rem, Sara Leuzzi, Vivien Moris, Caroline François, Marc Revol, Sarra Cristofari
The effectiveness of radiological imaging in detecting silicone breast implant rupture is, to this day, uncertain. The purpose of this study is to retrospectively evaluate the effectiveness of radiological imaging when diagnosing a rupture.The population taken into exam comprised 175 patients with 242 implants, among which 168 were used for breast reconstruction and 74 for aesthetic augmentation. All patients who underwent revision surgery, between January 2015 and June 2016, following breast augmentation or reconstruction, were included, regardless of any preoperative diagnosis of rupture had been made. The diagnosis of intracapsular rupture was verified intraoperatively and compared to the preoperative findings. Regarding preoperative diagnostic imaging methods, we compared Magnetic Resonance Imaging (MRI), Mammography and Ultrasonography (US).Among the 242 implants which have been explanted, 35 clinical ruptures were confirmed and compared with the related radiological findings. We reported 22 false positives and 15 false negatives. Ultrasonography was the least specific and least accurate method, due to its lowest positive predictive value (PPV) and negative predictive value (NPV). Mammography was the most specific and most accurate method with the highest PPV (96%). Surprisingly, MRI was the most sensitive, but neither the most specific nor the most accurate method despite having the highest NPV (98%).Comparing these three radiological techniques brought us to the conclusion that US associated with MRI can be useful for young patients. Mammography, which was characterized by high specificity and accuracy, could be useful in association with MRI in investigating patients over the age of 40.



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