Silicone axillary lymphadenopathy
Screening breast ultrasound; asymptomatic and had undergone bilateral breast augmentation with silicone implants for cosmetic purposes, 10 years before. A physical breast examination was normal and no lumps were noted in the axillary area.
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Ultrasound demonstrated two hyperechoic right axillary lymph nodes, with a well-defined anterior margin and poorly defined posterior margin causing a "snowstorm appearance" or “echo-dense noise” suggesting of intranodal silicone caused by an asymptomatic breast implant extracapsular rupture, confirmed subsequently by MRI (MRI images not available).
In silicone lymphadenopathy, the axillary lymph nodes may be painful and enlarged but are usually asymptomatic.
In women with breast implants, examination of the axilla by ultrasound is mandatory since silicone lymphadenopathy may be the only sign suggesting an intracapsular breast prosthesis rupture, which must be confirmed by a subsequent MRI.
The differential diagnosis of silicone lymphadenopathy includes breast cancer recurrence if the patient had a skin sparing mastectomy with reconstruction with a prosthesis