The diagnosis of silicone breast-implant rupture: clinical findings compared with findings at magnetic resonance imaging.
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.
Hölmich
Lisbet Rosenkrantz
LR
Danish Cancer Society, Institute of Cancer Epidemiology, Copenhagen, Denmark. Lisbet@cancer.dk
Fryzek
Jon P
JP
Kjøller
Kim
K
Breiting
Vibeke Bro
VB
Jørgensen
Anna
A
Krag
Christen
C
McLaughlin
Joseph K
JK
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
D001672:Biocompatible Materials; D020034:Silicone Gels