Silicone in the Axilla

IMAGING FINDINGS:​

Abnormal lymph node with hyperdense appearance on mammography. A sub-pectoral silicone implant is also noted. On ultrasound, there is a hazy, "snow storm" like appearance of increased echogenicity within a lymph node consistent with free (extra-capsular) silicone. 
 
WHY IT MATTERS:

1. Extracapsular or free silicone is often taken up by axillary lymph nodes after an implant rupture. It may be the first or most obvious sign of problems with implant integrity.
2. The gold standard imaging evaluation for identifying and classifying a silicone implant rupture is a breast MRI.

FURTHER READING:
Multimodality Imaging-based Evaluation of Single-Lumen Silicone Breast Implants for Rupture  (RadioGraphics, 2017)