Incidence of benign and malignant peri-implant fluid collections and masses on magnetic resonance imaging in women with silicone implants Journal Article


Authors: Sutton, E. J.; Dashevsky, B. Z.; Watson, E. J.; Tyagi, N.; Bernard-Davila, B.; Martinez, D.; Dogan, A.; Horwitz, S. M.; Cordeiro, P. G.; Morris, E. A.
Article Title: Incidence of benign and malignant peri-implant fluid collections and masses on magnetic resonance imaging in women with silicone implants
Abstract: Background: To assess the incidence of benign and malignant peri-implant fluid collections and/or masses on magnetic resonance imaging (MRI) in women with silicone implants who are being screened for silent implant rupture. Methods: The institutional review board approved this HIPAA-compliant retrospective study and waived informed consent. Women who underwent silicone implant oncoplastic and/or cosmetic surgery and postoperative implant-protocol MRI from 2000 to 2014 were included. Peri-implant fluid collections and/or masses were measured volumetrically. A benign peri-implant fluid collection and/or mass was pathologically proven or defined as showing 2 years of imaging and/or clinical stability. A malignant peri-implant fluid collection was pathologically proven. Incidence of peri-implant fluid collections and/or masses and positive predictive value (PPV) were calculated on a per-patient level using proportions and exact 95% confidence intervals (CIs). Fisher's exact test was used in the analysis to test statistical significance pre-defined as P-value < 0.05. Results: A total of 1070 women with silicone implants were included (mean age, 50.7 years; range, 40.4-53.8). Median time between reconstructive surgery and first MRI was 88.9 months (range, 0.8-1363.3). Eighteen women (1.7%) had a peri-implant fluid collection and/or mass: 15/18 (83.3%) had adequate follow-up; and only 1/15 was malignant implant associated anaplastic large cell lymphoma, with a PPV of 6.7% (95% CI: 0.003-0.0005). The median peri-implant fluid collection size was 89 mL (range, 18-450 mL). Conclusion: Peri-implant fluid collections and/or masses identified at silicone implant protocol breast MR imaging are rarely seen 24 months after reconstructive surgery. Image-guided fine-needle aspiration with flow cytometry may be warranted to evaluate for implant-associated lymphoma. © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Keywords: adult; human tissue; human cell; major clinical study; flow cytometry; nuclear magnetic resonance imaging; follow up; magnetic resonance imaging; incidence; cohort analysis; clinical protocol; pathology; retrospective study; biopsy; lymphoma; body fluids; breast implants; seroma; esthetic surgery; predictive value; body fluid; volumetry; prosthesis implantation; anaplastic large cell lymphoma; reconstructive surgery; fine-needle; human; female; priority journal; article; breast implant rupture; ultrasound guided fine needle aspiration
Journal Title: Cancer Medicine
Volume: 9
Issue: 10
ISSN: 2045-7634
Publisher: Wiley Blackwell  
Date Published: 2020-05-01
Start Page: 3261
End Page: 3267
Language: English
DOI: 10.1002/cam4.2189
PUBMED: 31568670
PROVIDER: scopus
PMCID: PMC7221432
DOI/URL:
Notes: Article -- Source: Scopus
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MSK Authors
  1. Elizabeth A Morris
    287 Morris
  2. Steven M Horwitz
    412 Horwitz
  3. Peter G Cordeiro
    253 Cordeiro
  4. Elizabeth Jane Sutton
    35 Sutton
  5. Bianca Bernard
    21 Bernard
  6. Neelam Tyagi
    75 Tyagi
  7. Ahmet Dogan
    230 Dogan
  8. Elizabeth   Watson
    4 Watson