title: How should we investigate breast implant rupture?
abstract: We aimed to examine a cohort of patients presenting with breast implant complications to establish the sensitivity and specificity of clinical examination, Ultrasound Scanning (US) and Magnetic Resonance Imaging (MRI) in the diagnosis of implant rupture, and to examine the correlation between US and MRI. We performed a 26-month retrospective review. Patients underwent US and MRI to exclude rupture. Results of US and MRI were compared prospectively for concordance, then retrospectively to clinical findings and surgical diagnosis. Thirty-four patients with 60 implants were reviewed. The sensitivities of clinical diagnosis, US, and MRI for rupture was 42%, 50%, and 83%, respectively, while the specificities were 50%, 90%, and 90%. The concordance between US and MRI was 87%. MRI is the investigation of choice for implant rupture. US is a valuable alternative with good concordance with MRI. When US is positive for implant rupture an MRI is not necessary to confirm the diagnosis. Knowledge of the sensitivity and specificity as well as the concordance between the two investigations is useful to ensure the appropriate use of available resources.
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Countess of Chester Hospital, Cheshire, United Kingdom.
authors.forename: Phoebe M
authors.initials: PM
authors.lastname: Hold
authors.forename: Shabana
authors.initials: S
authors.lastname: Alam
authors.forename: William J
authors.initials: WJ
authors.lastname: Pilbrow
authors.forename: Judith F
authors.initials: JF
authors.lastname: Kelly
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Everitt
authors.forename: Sanjiv K
authors.initials: SK
authors.lastname: Dhital
authors.forename: Ali
authors.initials: A
authors.lastname: Juma
mesh_terms: D019928:Breast Implantation / Q000009:adverse effects*; D018427:Breast Implants / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000191:economics; D011183:Postoperative Complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011475:Prosthesis Failure; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary / Q000191:economics