Silicone mastopathy

Case contributed by Dr Giorgio M Baratelli

Presentation

A 43-year-old Brazilian woman was referred because of bilateral breast tenderness.

Patient Data

Age: 43 years
Gender: Female
Ultrasound

Ultrasound image shows multiple globules of silicone appearing as small anechoic structures similar in appearance to simple breast cysts. These globules are surrounded by extensive free silicone, which appears as echogenic region associated with dirty acoustic shadowing, consistent with the characteristic “snowstorm” pattern.

Mammography

Mammography detects multiple bilateral high-density siliconomas.

MRI

MRI showed multiple masses at sites of silicone injections in the subcutaneous tissue.

Case Discussion

 

At the age of 20 she had a bilateral breast augmentation by liquid silicone injection at multiple sites. The shapes of her breast were still good; clinical examination detected a painful nodular texture of the glands; the axillary nodes were not palpable.

Management of the silicone mastopathy is not standardized. For mild cases, some sort of lump excision might work, but if silicone has been injected diffusely throughout the breasts excision (without doing a mastectomy) is probably impossible. The ultimate treatment for these patients is bilateral Nac-sparing mastectomy and reconstruction.

A watching policy and meticulous follow-up by MRI is recommended for these patients to allow early detection of breast cancer.

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Case information

rID: 21686
Case created: 11th Feb 2013
Last edited: 15th Aug 2017
System: Breast
Inclusion in quiz mode: Included

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