Objective. To evaluate the risk, diagnostic capabilities and surgical tactics for silicone lymphadenopathy following implant rupture.

Material and methods. Silicone breast implant ruptures were diagnosed in 72 patients after primary surgery. The period until rupture ranged from 6 months to 25 years. To assess the incidence of silicone changes, we analyzed ultrasound, CT and MRI data in 50 patients. Silicone lymphadenopathy was detected in two cases 5 and 6 years after implantation. A review of the literature for recent years is presented.

Results. MRI-verified lymph node enlargement following implant rupture was found in 40% of patients (20/50). There were non-specific changes in 16 cases (32%). Two patients had lymph node enlargement corresponding to silicone lymphadenopathy without morphological confirmation. Lymphadenopathy involved axillary, supraclavicular and intrathoracic lymph nodes with their enlargement up to 1.5—2.5 cm in two patients with implant ruptures 5 and 6 years after augmentation mammoplasty. Lymph node biopsy excluded cancer. In this patient, implants were removed simultaneously with lymph nodes. Histological examination revealed asteroid-like bodies and foreign body particles (silicone) in lymph nodes typical for silicone lymphadenopathy. Among 72 patients with implant ruptures, the incidence of silicone lymphadenopathy was 2% (2/72).

Conclusion. Silicone lymphadenopathy can complicate breast implant ruptures ≥ 5 years after mammoplasty. This complication requires differential diagnosis with malignancies. Lymph node biopsy is usually required for definitive diagnosis. Lymph node removal is necessary if clinical symptoms are present.

Keywords. silicone lymphadenopathy, breast implant, implant rupture, magnetic resonance imaging, computed tomography