Silicone Injection
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This is a 74-year-old female
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presenting for a screening mammogram.
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We can see that this study is technically adequate,
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you know, visualization of the pectoralis muscle,
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though it's difficult to see in this particular case.
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And the CC views, uh, look good as well. Right away,
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in this case, we can see there's
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some high-density material
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located in the posterior aspect of
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each breast, um, with some calcified
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material associated with it as well.
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And if we look closely on these SM views, we
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could see some of the areas of this material
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have more of a rim sort of calcification.
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Some of it is a little more heterogeneous, um,
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more fuzzy appearance, similar on the MLO view.
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You can see
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some rim-type calcifications, some denser
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stuff, maybe some more dense material.
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Looks like it gets up into the axillary
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regions bilaterally and extends
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up in towards the latissimus muscles.
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Now, of course, this would probably prompt anybody
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to go look in the clinical record and see what's
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going on or what this patient has had done.
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And in this particular case, these findings are
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related to, uh, injected silicone into the breast,
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um, for purposes of breast augmentation.
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Procedure is not typically done, uh, in the
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U.S., but we will occasionally see patients
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who have had this done in the past.
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Because of that, we see some of these calcified,
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uh, silicone granulomas, uh, which are the ones
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with the rim calcifications and dense material.
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And then, uh, we also see, uh,
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that there's other sort of
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more diffuse kind of dense material, which is,
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uh, also an appearance we see in this case.
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We will see some occasional associated sort
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of architectural distortion going with it.
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And we can see a lot of this silicone material
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will sort of move up into the axillary regions,
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which is taken up by the, uh, lymphatic system.
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And occasionally we'll see, um, that
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material even within the lymph nodes.
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This appearance can be seen as, in this
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case with injected silicone, which is
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multiple small injections of silicone.
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But we can also see a similar imaging appearance
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to these in the cases where a patient might have
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had, um, an extracapsular rupture of the silicone
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implant and then that implant subsequently removed.
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Anyway, you see, uh, large amounts of
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silicone deposits throughout the breast.
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Um, this makes screening, uh,
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for malignancies very difficult.
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Uh, and you, you just take a careful look,
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uh, throughout the whole breast, trying to
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look past all the dense material, see if
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you can see anything that looks abnormal,
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looks, changes, change from prior exams.
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Otherwise, we can call this benign.
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There's nothing that we need to do.
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Uh, there's no particular surgical
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intervention that's needed, and the
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patient can just have routine screening.
Ryan W. Woods, MD, MPH
Assistant Professor of Radiology
University of Wisconsin School of Medicine and Public Health
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