49-year-old female to assess for right silicone implant rupture or fracture. History of bilateral nipple sparing mastectomy and silicone implant reconstruction 11/2012. Now with right implant shape change, firm corner from ripple, 1 cm thickening at 6 oclock along IMF History: right reconstructed breast implant shape change, skin thickening Status post bilateral mastectomies. There are postsurgical changes of bilateral silicone implants without evidence of intracapsular or extracapsular rupture. There is a focus of nonmass enhancement at the 5 to 6:00 position of the right reconstructed breast abutting the skin and implant which measures approximately 2.5 x 0.7 x 0.4 cm (ML X AP X SI). No suspicious enhancement is seen within the left reconstructed breast.There is an enhancing mass in the right lower axillary region posteriorly at approximately the 10:00 position which measures 0.7 x 0.5 x 0.9 cm and has T2 characteristics suggesting a low-lying lymph node.
1.Nonmass enhancement at the 5 to 6:00 position of the right breast between the implant and the skin. Differential includes infection/inflammation or recurrent disease. Recommend MR directed ultrasound for further evaluation.2.No evidence of implant rupture.BIRADS: 0 - INCOMPLETE; Need additional imaging evaluationRECOMMENDATION: E - Additional Mammo/Ultrasound Workup Required.