title: Prevalence of rupture of silicone gel breast implants revealed on MR imaging in a population of women in Birmingham, Alabama.
abstract: OBJECTIVE
  Silicone gel breast implants have been reported to rupture, but the prevalence of implant rupture in an unreferred population of women is not known. The objective of this study was to assess the prevalence of implant rupture and the presence of extracapsular silicone gel in an unreferred population of women without regard to the absence or presence of any local or systemic symptoms.
  
  
  METHODS
  Women identified as part of a National Cancer Institute cohort study on breast implants, living in the Birmingham, AL, area were invited to undergo MR imaging of their current silicone gel breast implants at the Kirklin Clinic at the University of Alabama at Birmingham. Three radiologists independently examined and rated all MR images for signs of implant rupture and extracapsular silicone.
  
  
  RESULTS
  A total of 344 women with silicone gel breast implants underwent MR imaging. Breast implant rupture was reported by at least two of three radiologists for 378 (55.0%) of the 687 implants in this study. Another 50 implants (7.2%) were rated as indeterminate (suspicious) for rupture. A majority of women in this study, 265 (77.0%) of 344, had at least one breast implant that was rated as ruptured or indeterminate. Radiologists also agreed that silicone gel could be seen outside the fibrous capsule that forms around the implant in 85 (12.4%) of the 687 implants affecting 73 women (21.2%). Factors that affected implant rupture were implant age and location (submuscular or subglandular). The median implant age at rupture was estimated to be 10.8 years with a 95% confidence interval of 8.4-13.9 years.
  
  
  CONCLUSIONS
  The prevalence of silent or occult silicone gel breast implant rupture is higher than was previously suspected. Most women in this study had MR imaging evidence of at least one ruptured silicone gel breast implant.
authors.affiliation: Office of Surveillance and Biometrics, Center for Devices and Radiological Health, Food and Drug Administration, 1350 Piccard Dr., HFZ-541, Rockville, MD 20850, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Brown
authors.forename: M S
authors.initials: MS
authors.lastname: Middleton
authors.forename: W A
authors.initials: WA
authors.lastname: Berg
authors.forename: M S
authors.initials: MS
authors.lastname: Soo
authors.forename: G
authors.initials: G
authors.lastname: Pennello
mesh_terms: D000328:Adult; D000368:Aged; D018427:Breast Implants; D003430:Cross-Sectional Studies; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D015588:Observer Variation; D012422:Rupture, Spontaneous; D020034:Silicone Gels
chemical_list: D020034:Silicone Gels