Clinical:
- A 45 years old lady
- Came for screening mammogram
- Asymptomatic
- No family history of breast cancer
- History of free-silicone injection for breast augmentation many years before
Mammogram findings:
- There are bilateral and multiple high density opacities in both breasts
- These opacities are of various sizes and shapes
- It causes obliteration of the normal breast tissue shadows
- No obvious distortion of shape is seen
- No nipple retraction or skin thickening
Diagnosis: Silicone granulomas/siliconomas.
Discussion:
- Direct injection of free silicone into the breast has been prohibited by US FDA in the 1970s due to its many adverse effects.
- However, in our country it is performed illegally mainly by non-trained personnel.
- The dverse effects of this injection included lymphadenopathy, infection, formation of granulomatous masses (siliconoma), and fibrosis.
- The resulting nodularity of this silicone mastopathy made it difficult to differentiate fibrous silicone breast masses from carcinoma at physical examination because both may manifest as a palpable mass.
- At mammography, these silicone globules appear as multiple radiopaque globules, some with a rim of calcification, which distort the breast parenchyma.
- It presents a dilemma for the radiologist because it interferes with the interpretation of mammographic findings and can easily obscure breast carcinoma.
