MR Findings of Siliconoma in Interstitial Silicone Injection Mammoplasty Patients

PURPOSE: To assess the MR findings of siliconomas (silicone granulomas) in patients with interstitial silicone injection mammoplasty. MATERIALS AND METHODS: Women with interstitial silicone injection mammoplasty were referred for this study on the basis of clinical findings of palpable mass. Nine patients with 18 augmentated breasts underwent axial and sagittal MR imaging, and the results were analysed in terms of their size, shape, margin, signal intensity, enhancement pattern, distribution and adjacent parenchymal distortion. We undertook in-vitro MR imaging of silicone, paraffin, fat, and water, and then compared their signal intensities at each sequence. RESULTS: Siliconomas were seen as well-defined low-signal-intensity nodules at T1WI and high-signal-intensity nodules at T2WI. There was no demonstrable contrast enhancement. Where there was breast cancer in which heterogeneous signal intensity was observed at T1 -and T2WI, together with heterogeneous enhancement, siliconomas were well differentiated from the tumor mass. At in-vitro MR imaging of silicone, paraffin, fat and water, paraffin showed a very low signal intensitiy at all pulse sequences but silicone showed low signal intensity at T1-fat-suppressed T1WI and high signal intensity at T2-and water-suppressed T2WI. CONCLUSION: MRI allows clear differentiation of siliconoma from fat and fibroglandular tissue, and can therefore, reveal anatomical details and detect lesions in patients with interstitial silicone injection mammoplasty.

Mammographic Changes in Postmenopausal Women: Comparative Effects between Continuous Combined Hormone and Single Estrogen Replacement Therapy

PURPOSE: As the use of hormone replacement therapy for the menopausal women increases, some caution is advised, since there is an increased risk of breast cancer. Accordingly, the importance of regular mammography has been addressed. This cross-sectional study analyzed the effects of different hormone therapies on mammographic density. MATERIALS AND METHODS: Sixty-seven postemenopausal women who had completed one year of hormone therapy and had undergone follow-up mammography, were divided into two groups : Group I : continuous conjugated equine estrogen, 0.625 mg, plus continuous medroxyprogesterone acetate, 2.5 mg (n=48), Group II : continuous conjugated equine estrogen 0.625 mg (n=19). The mammograms were read by two radiologists. RESULTS: With regard to the radiologists involved, interobserver reliability (kappa) was 0.70 and intraobserver reliability (kappa) was 0.51 and 0.67. Before hormone therapy, factors related to decreased mammographic density were age and number of full term pregnancies (p<0.05). After one year of hormone therapy, body fat showed a significant increase (p<0.05), but in spite of this, increased mammographic density induced by hormone therapy remained significantly high (p<0.05). Compared with Group II, Group I showed a significant increase in mammographic density (p<0.05). In Group I, mammographic density increased from P2 to DY pattern in two cases, but there was no such change in Group II. CONCLUSION: The increase of mammographic density seen in Group II was much more significant statistically than that seen in Group I. The mammograms of women who have undergone continuous combined hormone therapy should therefore be interpreted very cautiously.