Invasive breast cancer after breast augmentation
A 51 year old woman, who had undergone augmentation mammoplasty when she was 30, was routinely examined in the breast clinic. Clinical examination demonstrated a small, mobile nodule in in the upper central quadrant of the right breast.
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Breast ultrasounds show an hypoechoic, not homogeneous, avascular round nodule of 10 mm, with indistinct margins and without posterior acoustic shadowing.
The implant shell is visualized as a thin and continuous echogenic line at the muscle-implant interface.
Core needle biopsy of the nodule showed a invasive ductal carcinoma (B5).
A lumpectomy by a periareolar incision, without opening the capsule of the implant, and a sentinel node biopsy was performed. The tumor was grade G2 stage pT1b (10 mm) pNmi (sn) M0, estrogen and progesterone receptors positive and HER2/neu- negative.
The risk of breast cancers in women undergoing breast augmentation is not increased; indeed the epidemiological observations show a lower incidence of breast cancer in augmented women, probably related to a reduced amount of glandular tissue (this hypothesis has not been confirmed).
Breast sonography, after a clinical examination, can be a simple and helpful tool in cancer detection in augmented women; it must be followed by contrast-enhanced MRI (especially for suspicion masses), FNA or core biopsy.