Appropriateness of MRI scanning in the detection of ruptured implants used for breast reconstruction

This case report highlights the problems associated with ruptured silicone breast implants used for breast reconstructive purposes. The patient originally presented with vague symptoms and signs to her GP and was extensively investigated over a period of years for left-sided chest/abdominal pain. Two separate scanning modalities were used prior to her being seen by either of the main authors and although none were employed specifically to assess for implant rupture, neither detected any free silicone around the hemithorax. The authors suggest that patients who have undergone breast reconstruction with a silicone implant may present in a manner not suggestive of implant damage. In such cases, where the silicone can extend over larger anatomical distances and where side-effects can be damaging the investigation of choice should be MRI scanning which has a greater accuracy for detecting free silicone and defining the extent of spread.