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Monitoring the axilla in patients with silicone gel implants
D A Kulber1, D Mackenzie, J H Steiner
1Department of Plastic Surgery, New York Hospital, Cornell Medical Center, NY 10021, USA.
Annals of Plastic Surgery
|December 1, 1995
Summary
Silicone breast implants can migrate, causing a foreign body reaction in axillary lymph nodes. Biopsies are crucial for detecting both silicone migration and potential coincidental breast cancer.
Area of Science:
- Plastic Surgery
- Oncology
- Radiology
Background:
- Silicone migration beyond the breast implant capsule can occur due to implant failure.
- Axillary lymph node involvement is a potential complication of silicone breast implants.
Purpose of the Study:
- To investigate silicone migration in patients with breast implants undergoing axillary lymph node biopsy.
- To assess the diagnostic utility of axillary evaluation in patients with silicone breast implants.
Main Methods:
- Retrospective review of 23 patients with silicone implants who underwent axillary lymph node biopsy.
- Utilized mammography, ultrasonography, magnetic resonance imaging, and fine-needle aspiration for axillary evaluation.
Main Results:
- All biopsies showed foreign body reaction consistent with silicone migration.
- Breast cancer was detected in 7 patients (5 in augmentation, 2 in reconstruction) via axillary biopsy.
- Silicone granuloma was observed in conjunction with breast cancer in some cases.
Conclusions:
- Routine axillary evaluation is mandatory for all patients with silicone breast implants.
- An algorithmic approach to diagnosing axillary masses is recommended, particularly for augmentation patients.
- Axillary masses require biopsy regardless of screening study results due to potential coincidental breast cancer.