Evaluating Breast Implant Screening Guidelines in Breast Cancer Reconstruction.

IF 1.4 4区 医学 Q3 SURGERY
Meeti Mehta, Casey Zhang, Shayan Sarrami, Vanessa Mroueh, Carolyn De La Cruz
{"title":"Evaluating Breast Implant Screening Guidelines in Breast Cancer Reconstruction.","authors":"Meeti Mehta, Casey Zhang, Shayan Sarrami, Vanessa Mroueh, Carolyn De La Cruz","doi":"10.1097/SAP.0000000000004329","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>In 2020, the US Food and Drug Administration updated its surveillance recommendations for breast implant rupture to ultrasound screening or magnetic resonance imaging (MRI) 5-6 years following silicone implant placement, with repeat screening every 2-3 years thereafter. This study evaluates the risk of implant rupture and assesses the utility of routine surveillance MRIs in diagnosing implant rupture.</p><p><strong>Methods: </strong>We performed a retrospective review of patients with implant-based reconstruction for breast cancer with a single surgeon between 2012 and 2017. Inclusion criteria included a 5-year minimum follow-up period. Analysis was performed to elucidate rupture rate and associated factors.</p><p><strong>Results: </strong>A total of 376 patients underwent reconstruction with saline (13%) and silicone implants (87%). Seventy-five (20%) underwent routine MRI screening within 5-6 years of surgery. Implant rupture occurred in 26 patients (7%). Average time from implant placement to rupture was 5.9 ± 4.0 years. Fifty-nine percent of silicone implant ruptures were diagnosed by MRI screening. Thirty-eight percent of silicone implant ruptures presented without clinical symptoms and were identified on routine MRI screening. All saline implant ruptures presented with clinical symptoms. On imaging, ruptures were classified as intracapsular (81%) or extracapsular (12%). Seventy-three percent of ruptures were confirmed intraoperatively during implant replacement. Median time for rupture diagnosis to implant removal/replacement was 3 months (range, 0.5-21 months).</p><p><strong>Conclusions: </strong>MRI screening for silicone implant rupture in implant-based breast reconstruction had a 59% detection rate, with relatively low patient adherence (20% within 5-6 years after surgery), highlighting the challenges of screening. Patients should be counseled on the risk of implant rupture and the likelihood of needing replacement during their lifetime.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4S Suppl 2","pages":"S173-S176"},"PeriodicalIF":1.4000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Plastic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/SAP.0000000000004329","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: In 2020, the US Food and Drug Administration updated its surveillance recommendations for breast implant rupture to ultrasound screening or magnetic resonance imaging (MRI) 5-6 years following silicone implant placement, with repeat screening every 2-3 years thereafter. This study evaluates the risk of implant rupture and assesses the utility of routine surveillance MRIs in diagnosing implant rupture.

Methods: We performed a retrospective review of patients with implant-based reconstruction for breast cancer with a single surgeon between 2012 and 2017. Inclusion criteria included a 5-year minimum follow-up period. Analysis was performed to elucidate rupture rate and associated factors.

Results: A total of 376 patients underwent reconstruction with saline (13%) and silicone implants (87%). Seventy-five (20%) underwent routine MRI screening within 5-6 years of surgery. Implant rupture occurred in 26 patients (7%). Average time from implant placement to rupture was 5.9 ± 4.0 years. Fifty-nine percent of silicone implant ruptures were diagnosed by MRI screening. Thirty-eight percent of silicone implant ruptures presented without clinical symptoms and were identified on routine MRI screening. All saline implant ruptures presented with clinical symptoms. On imaging, ruptures were classified as intracapsular (81%) or extracapsular (12%). Seventy-three percent of ruptures were confirmed intraoperatively during implant replacement. Median time for rupture diagnosis to implant removal/replacement was 3 months (range, 0.5-21 months).

Conclusions: MRI screening for silicone implant rupture in implant-based breast reconstruction had a 59% detection rate, with relatively low patient adherence (20% within 5-6 years after surgery), highlighting the challenges of screening. Patients should be counseled on the risk of implant rupture and the likelihood of needing replacement during their lifetime.

求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.70
自引率
13.30%
发文量
584
审稿时长
6 months
期刊介绍: The only independent journal devoted to general plastic and reconstructive surgery, Annals of Plastic Surgery serves as a forum for current scientific and clinical advances in the field and a sounding board for ideas and perspectives on its future. The journal publishes peer-reviewed original articles, brief communications, case reports, and notes in all areas of interest to the practicing plastic surgeon. There are also historical and current reviews, descriptions of surgical technique, and lively editorials and letters to the editor.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信