Evaluation of techniques for detecting breast implant rupture

Over the past few years, the safety of silicone gel-filled breast implants has raised a great deal of concern among women, for study reports have suggested a link between such implants and the occurrence of local and systemic complications. Because of this potential health risk, the sale of these implants was halted, even if the toxicity of silicone has not been demonstrated by scientific data. The most frequent local complication is implant shell rupture, which results in exposure of the body to silicone and in a loss of esthetics.

To issue recommendations concerning the detection of breast implant rupture, one must, on the one hand, examine the efficacy, accessibility and cost of the imaging techniques that are normally used, i.e., mammography, ultrasonography and MRI, and, on the other hand, establish that silicone has no toxic effects. In light of these criteria, AETMIS recommends a mammographic examination followed by a breast ultrasound as the first-line strategy in all cases where implant rupture is suspected on clinical examination. MRI should be reserved for those cases where the results of these two techniques are equivocal or suspicious or when the results of the clinical and radiological examinations are discordant.