Presentation
Screening mammogram. History of breast augmentation procedure 15-20 years prior.
Patient Data
Asymmetric, rounded amorphous densities are present bilaterally, surrounded by less dense breast parenchyma. A more focal, dense circumscribed mass is also noted centrally in the left breast. There are no discrete breast "implants", nor is this the typical appearance of free silicone injection.
Scattered dystrophic calcifications present.
Selected images from right breast ultrasound study demonstrate a circumbscribed collection with mixed internal echoes, located deep to the glandular tissue.
Case Discussion
This patient has a history of prior augmentation mammoplasty by injection. The substance injected is not known, however the appearance is not typical of silicone injection which typically presents as multiple very dense masses - much denser than this - with variable rim calcification.
It is likely to represent hydrophillic polyacrylamide gel (PAAG) injection.
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