Free silicone can have devastating longterm complications and this case report demonstrates the difficulty of screening mammograms and ultrasound in patients who have silicone in their breasts. A 49 year old woman was seen in a clinical setting for a symptomatic mass in her breasts - in the setting of free silicone. Initial examination revealed a typical snowstorm effect that is typically seen on ultrasound evaluation of the soft tissue in patients who have liquid silicone.
Initial evaluation of the palpable and symptomatic nodule revealed a typical inflammatory reaction to silicone seen in granulomas. The patient was then given analgesics for pain and reassured. She was then seen for a second opinion and the option of excisional biopsy was made as there was no clear exclusion of cancer.
Histologic examination then revealed an invasive mammary carcinoma with apocrine component, GATA 3 positive, ER/PR negative and cerB2 positive with positive margins.
The problem presents itself with surgeons who are evaluating and managing patients with silicone disease. Even though there is a presumed diagnosis of siliconoma in patients who have free silicone injections, there is always a possibility that the subcutaneous mass could exhibit some other type of etiology, including cancer.
If you have silicone disease, you should always have granulomas and subcutaneous nodules evaluated by your surgeon. Although silicone granulomas are rare, evaluation is always prefaced on the assumption that there is a small risk of the nodules being cancerous or malignant.
Our Los Angeles plastic surgery office evaluates and treats patients with silicone disease. If you are concerned about your silicone injections, schedule a consultation with Dr. Karamanoukian to discuss options for silicone removal.
Kare Plastic Surgery
Experts in Silicone Removal from the Breasts and Body
804 7th Street
Santa Monica, CA 90403
(310) 998-5533
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