Silicone axillary lymphadenopathy

Case contributed by Dr Giorgio M Baratelli

Presentation

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.

Patient Data

Age: 40 years
Gender: Female

Ultrasound axilla

Modality: Ultrasound

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).

Case Discussion

 

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

 

 

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Case Information

rID: 51057
Case created: 2nd Feb 2017
Last edited: 8th Feb 2017
System: Breast
Inclusion in quiz mode: Included

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