Ultrasound-guided percutaneous injection of triamcinolone acetonide for treating capsular contracture in patients with augmented and reconstructed breast.
OBJECTIVE
To evaluate ultrasound (US)-guided treatment of capsular contracture (CC) in patients with reconstructed/augmented breast.


METHODS
Twenty-five patients with grade IV CC were treated with peri-implant US-guided injection of triamcinolone acetonide. Before/after treatment, maximum capsular thickness (MCT) was measured by ultrasound and pain assessed with visual analogue score (pain-VAS). Patients with pain relief at 1 month were considered early responders (ERs). Another injection was performed in patients without pain relief at 1 month (late responders, LRs).


RESULTS
One patient (treated with chemo-radiotherapy) experienced severe pain and local reaction after the second injection, requiring surgery. Twenty-four patients had baseline MCT of 1.8 ± 0.3 mm and pain-VAS of 4.9 ± 0.5, the baseline MCT of 19 ERs (1.7 ± 0.2 mm) being significantly lower than that of 5 LRs (2.1 ± 0.2 mm) (p = 0.030). ERs had significantly reduced MCT and pain-VAS at one (1.1 ± 0.3 mm; 1.5 ± 0.5) and 6 months (1.1 ± 0.2 mm; 0.9 ± 0.7, respectively) (p < 0.001). At 1 month, LRs had a significantly reduced MCT (1.6 ± 0.1 mm, p = 0.042) but non-significantly changed pain-VAS (4.7 ± 0.2); 5 months later, MCT reached 1.0 ± 0.1 mm, pain-VAS reached 0.8 ± 0.5 (p < 0.044). Significant correlation between the relative variation of MCT and pain-VAS (1 month/baseline) was found.


CONCLUSIONS
US-guided injection of triamcinolone acetonide is effective in treating grade IV CC.
Sconfienza
Luca Maria
LM
Facoltà di Medicina e Chirurgia, Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Viale Benedetto XV 6, 16132, Genova, Italy. io@lucasconfienza.it
Murolo
Carmelina
C
Callegari
Simone
S
Calabrese
Massimo
M
Savarino
Edoardo
E
Santi
Pierluigi
P
Sardanelli
Francesco
F
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001941:Breast Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000209:etiology; D018427:Breast Implants / Q000009:adverse effects*; D003286:Contracture / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage*; D018084:Ultrasonography, Interventional / Q000379:methods*
D000893:Anti-Inflammatory Agents; D014221:Triamcinolone