A technology assessment report 1 on mammography and MRI in detecting breast silicon implant rupture was abstracted in the Health Technology Assessment Database 2. Breast implant rupture is a local complication that has mainly aesthetic consequences. There is no consensus regarding the indication for removal an implant with asymptomatic intracapsular rupture. MRI seems to be better than mammography in detection of intracapsular rupture but is slightly less specific than mammography in detecting extracapsular rupture and its use could result in the removal of intact implants. If there is a clinical presumption of rupture, a mammographic examination followed by a breast ultrasound is the recommended strategy of first recourse. If the results of these two examinations are normal, it is advisable to provide a clinical follow-up. If either of these examination reveals an extracapsular rupture, the implant is removed. If the results of these examinations reveal an intracapsular rupture, some women may choose to keep their implants and to undergo a periodic clinical follow-up. Lastly, if the results are equivocal or suspicious or do not agree with the findings of the clinical examination, MRI is performed.
Comment: Mammography in implanted breasts should be performed extra carefully as squeezing may cause rupture of the implant.
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