ABSTRACT
A solitary dilated duct visualized by mammography is a rare event. According to the latest edition of BI-RADS® it is classified as category 4. This series of cases shows complementary ultrasound of a solitary dilated duct can reduce false-positive results on mammography.
ABSTRACT
BACKGROUND: To determine whether there is correlation between magnetic resonance imaging (MRI) findings and breast elastography to differentiate seroma/hematoma from silicone-induced granuloma of breast implant capsule (SIGBIC). METHODS: Prospective study of 99 patients with breast implants submitted to breast MRI during the period from February 1 to May 1, 2017. Patients who present MRI findings of seroma/hematoma or SIGBIC were submitted to a complementary ultrasound elastography study to evaluate the correlation of the results. The criteria adopted for the diagnosis of granuloma by MRI were heterogeneous hypersignal in the T2-weighted sequences, late contrast enhancement, and black drop sign. Lesions that did not enhance after the use of contrast were considered as seroma/hematoma. By elastography, the results were considered positive for granuloma when presented as hard lesions, whereas seroma/hematoma presented as soft lesions. RESULTS: Of the 99 patients evaluated, 15 were included in the study. Of the 15 patients, 9 had solid intracapsular MRI masses, whereas 6 presented collections without contrast enhancement. The complementary elastography study showed correlation with MRI results in all cases of SIGBIC and seroma/hematoma, being elastography able to differentiate lesions from solid to cystic. CONCLUSIONS: Elastography of intracapsular masses in breast implants presented results compatible with those found by MRI to differentiate solid lesions from collections.
ABSTRACT
Complications resulting from the placement of silicone breast implants are becoming more frequent in our clinical practice. This is due to the increase in breast aesthetic surgeries at the beginning of the century, where breast augmentation using silicone implants was the main intervention performed. Generally, studies that discuss the complications of breast implants are restricted to reports of intra- or extra-capsular ruptures, contractures and haematomas. Currently, much importance has been given to anaplastic large cell lymphoma (ALCL) as a more severe complication related to silicone implants. Recently, granuloma formation induced by silicone particle bleeding from intact breast implants has been described when the free silicone comes into contact with the fibrous capsule of the implant. Few studies have demonstrated the characteristics and diagnostic keys for this entity. The objective of this study is to present cases of SIGBIC diagnosed in our service and to discuss the main findings that allow its diagnosis. Teaching Points ⢠Breast implants induce fibrous capsule formation at the periphery of the implant. ⢠Gel bleeding is inherent in all types of silicone breast implants. ⢠Gel bleeding induces silicone-induced granuloma of breast implants. ⢠Main diagnostic tips: heterogeneous mass, black-drop sign and late enhancement.
ABSTRACT
Primary breast lymphoma is a rare disease and accounts for 0.5% of cases of breast cancer. Most primary breast lymphomas develop from B cells, and the involvement of T cells is rare. Anaplastic large cell lymphoma (ALCL) is a recently discovered T-cell lymphoma associated with breast implants. Only a few cases have been reported to date. It is believed that the incidence of ALCL is increasing because of the increasing number of breast implants. The clinical presentation is variable and can manifest as a palpable mass in the breast or armpit, breast pain, or capsular contracture. Because of the rarity of the disease and the lack of knowledge to date, clinical diagnosis is often delayed, with consequent delays in treatment. The cause and pathogenesis have not been fully elucidated, and there are no evidence-based guidelines for diagnosis, treatment, or follow-up of this disease. We present a review of cases of patients with silicone breast implants, including ALCL, a rare type of breast cancer that is still under study, and silicone-induced granuloma of breast implant capsule and its differential diagnosis, and discuss if a silicone-induced granuloma of breast implant capsule could be the precursor of the disease.
ABSTRACT
CONTEXT: Although several studies have evaluated the frequency of adverse drug reactions (ADRs) and drug-drug interactions (DDIs) in general medicine, few studies have looked at the epidemiology of adverse drug events (ADEs) in oncology. OBJECTIVES: We sought to investigate how many hospital admissions in oncology are related to a DDI or an ADR. METHODS: All cancer patients admitted to an oncology ward during an eight-month period had their charts retrospectively evaluated for reasons of hospitalization, using a 4-point scale (definitely, probably, possibly, or unlikely associated) to classify admissions by their probability of being associated with either a DDI or an ADR. RESULTS: From September 2007 to May 2008, there were 550 hospital admissions and 458 were eligible. Among unplanned admissions (n=298), 39 (13.0%, 95% confidence interval [CI] 9.4%-17.4%) were considered to be associated with an ADE, 33 (11.0%, 95% CI 7.7%-15.2%) with an ADR, and six (2.0%, 95% CI 0.7%-4.3%) with a DDI. The most common DDIs involved warfarin, captopril, and anti-inflammatory agents, and the most frequent ADR was neutropenic fever post-chemotherapy. Most patients were discharged completely recovered, but two patients died. CONCLUSION: Approximately one in 10 unplanned hospitalizations of cancer patients is associated with an ADE. Prospective and population-based studies are warranted to evaluate their magnitude in oncology.
