Film screen mammography and sonography in the evaluation of breast prosthesis integrity

The purpose of this study was to determine the sensitivity and specificity of film screen mammography and sonography in detecting implant rupture and identify findings significantly associated with rupture, The sensitivity and specificity of preoperative mammograms and sonograms performed on 139 consecutively removed implants were determined retrospectively from preoperative imaging reports. Mammograms and sonograms were then reviewed to identify findings associated with implant rupture. Multivariate and univariate analyses were performed with adjustments made for date of implant placement. The prevalence of rupture was 62%. Sensitivity and specificity from preoperative reports were 68% and 72% (individually, mammography 51% and 96%, respectively; sonography 85% and 57%, respectively). Protrusions (smooth and irregular) were highly associated with rupture (p < 0.05), Extracapsular silicone was also associated with rupture (p < 0.1). The sonographic 'snowstorm' pattern was significant in the univariate analysis, It was concluded that, although not as sensitive as MRI, mammography and sonography can demonstrate specific findings associated with ruptured implants. For patients with implants undergoing routine breast cancer screening, mammography and adjunctive sonography are still useful and readily available for detecting rupture.

Duke Scholars

Author Mary Scott Campbell Soo Radiology, Breast Imaging

Author Daniel Carl Sullivan Radiology

Author Gregory S. Georgiade Surgery, Plastic, Maxillofacial, and Oral Surgery