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Untreated silicone breast implant rupture . Implant rupture is a well-known complication of breast implant surgery that can pass unnoticed by both patient and physician . To date , no prospective study has addressed the possible health implications of silicone breast implant rupture . The aim of the present study was to evaluate whether untreated ruptures are associated with changes over time in magnetic resonance imaging findings , serologic markers , or self-reported breast symptoms . A baseline magnetic resonance imaging examination was performed in 1999 on 271 women who were randomly chosen from a larger cohort of women having cosmetic breast implants for a median period of 12 years ( range , 3 to 25 years ) . A follow-up magnetic resonance imaging examination was carried out in 2001 , excluding women who underwent explantation in the period between the two magnetic resonance imaging examinations ( n = 44 ) . On the basis of these examinations , the authors identified 64 women who had at least one ruptured implant at the first magnetic resonance imaging examination and , for comparison , all women who had intact implants at both examinations ( n = 98 ) . Magnetic resonance images from the two examinations were compared and changes in rupture configuration were evaluated . Comparisons were also made for self-reported breast symptoms occurring during the study period and for changes in serum values of antinuclear antibodies , rheumatoid factor , and cardiolipin antibodies immunoglobulin G and immunoglobulin M. The majority of the women with implant rupture had no visible magnetic resonance imaging changes of their ruptured implants . For 11 implants ( 11 percent ) in 10 women , the authors observed progression of silicone seepage , either as a conversion from intracapsular into extracapsular rupture ( n = 7 ) , as progression of extra-capsular silicone ( n = 3 ) , or as increasing herniation of the silicone within the fibrous capsule ( n = 1 ) ; however , in most cases , these changes were minor . Some changes could be ascribed to trauma , but others seemed spontaneous . There was no increase in levels of autoantibodies during the study period in either study group . Women with untreated implant ruptures reported a significant increase in nonspecific breast changes ( odds ratio , 2.1 ; 95 percent confidence interval , 1.2 to 3.8 ) compared with women without ruptures . On the basis of this first study of women with untreated silicone breast implant rupture , the authors conclude that implant rupture is a relatively harmless condition , which only rarely progresses and gives rise to notable symptoms . Even so , because of a small risk of silicone spread , the authors suggest that women with implant ruptures be followed clinically , if not operated on . Because implant ruptures often occur asymptomatically , any woman with silicone implants , regardless of rupture status , should be evaluated at regular intervals .
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Intervention_Surgical
implant ruptures
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Outcome_Other
magnetic resonance imaging changes
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Outcome_Physical
silicone seepage
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Outcome_Physical
levels of autoantibodies
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Outcome_Physical
nonspecific breast changes
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Participant_Condition
Untreated silicone breast implant rupture .
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Participant_Sample-size
271
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Participant_Sex
women
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Participant_Sex
women
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Participant_Condition
having cosmetic breast implants for a median period of 12 years
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Participant_Age
( range , 3 to 25 years
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Participant_Sample-size
64
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Participant_Sex
women