Mammography after prosthesis placement for augmentation or reconstructive mammoplasty

Mammograms of 59 women who underwent placement of a prosthesis for augmentation or reconstructive mammoplasty were retrospectively reviewed. Free silicone was used in five women, retroglandular prostheses in 40, and subpectoral implants in 14. Abnormalities of prosthesis contour were seen only in eight women with retroglandular implants. In another four women, retroglandular prostheses became calcified. In women who received free-silicone injections, coarse calcifications developed in three, and gross nodularity with calcified silicone granulomas developed in one. Five palpable masses developed, three of which were malignant; four masses were in breasts augmented with a retroglandular prosthesis, and they could not be detected with mammography. The mass that developed in a woman with a subpectoral prosthesis could be seen at mammography. The only nonpalpable malignancy detected with mammography was in a breast with a retroglandular prosthesis and contained microcalcifications. The authors conclude that in women with retroglandular prostheses, masses may often be obscured on mammograms by compressed, dense glandular tissue.