title: The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging.
abstract: The objective was to evaluate the usefulness of clinical examination in the evaluation of breast-implant integrity, using the diagnosis at magnetic resonance imaging (MRI) as the "gold standard." Fifty-five women with 109 implants underwent a breast examination either just before or shortly after an MRI examination. Twenty-four of 109 implants were clinically diagnosed with possible rupture or rupture. Eighteen of the 24 implants were ruptured according to the MRI examination (75%). Eighty-five implants were clinically classified as intact, and 43 of these were actually ruptured at MRI (51%). The sensitivity of the clinical examination for diagnosing rupture was thus 30% and the specificity 88%. The positive predictive value of a clinical diagnosis of rupture was 75%, and the negative predictive value was 49%. In this study, we found that when a clinical examination is used as the sole diagnostic tool to identify implant rupture, neither the sensitivity nor the specificity is acceptable.
authors.affiliation: Danish Cancer Society, Institute of Cancer Epidemiology, Copenhagen, Denmark. Lisbet@cancer.dk
authors.forename: Lisbet Rosenkrantz
authors.initials: LR
authors.lastname: Hölmich
authors.forename: Jon P
authors.initials: JP
authors.lastname: Fryzek
authors.forename: Kim
authors.initials: K
authors.lastname: Kjøller
authors.forename: Vibeke Bro
authors.initials: VB
authors.lastname: Breiting
authors.forename: Anna
authors.initials: A
authors.lastname: Jørgensen
authors.forename: Christen
authors.initials: C
authors.lastname: Krag
authors.forename: Joseph K
authors.initials: JK
authors.lastname: McLaughlin
mesh_terms: D000328:Adult; D001672:Biocompatible Materials / Q000009:adverse effects; D019928:Breast Implantation / Q000295:instrumentation*; D018427:Breast Implants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010808:Physical Examination; D011183:Postoperative Complications; D011475:Prosthesis Failure; D012680:Sensitivity and Specificity; D020034:Silicone Gels / Q000009:adverse effects; D016037:Single-Blind Method
chemical_list: D001672:Biocompatible Materials; D020034:Silicone Gels