MRI Screening for Silicone Breast Implants?
- Asked by Meeko in san jose
- 4 years ago
Do silicone breast implants need MRI screening every 2 to 3 years?
MRI every three years for silicone implants
Although I tell my patients about the FDA recommendation that patients with silicone implants obtain MRI's every 3 years, I can tell you that none of them follow this recommendation. My patients obtain an MRI only when they feel that something may be wrong with their implants.
MRI screening is not mandatory
When the FDA approved the use of silicone implants, for all individuals who qualified, in November of 2006 one of their recommendations was to obtain an MRI every 2-3 years to detect any evidence of a rupture. The key word is "recommend" and not require.
The reality is unless you notice a problem, ie your breast becoming hard or experiencing pain, there is no need to obtain an MRI every 2-3 years. It is best to be evaluated by your plastic surgeon and decide on how to proceed.
It is also very difficult to have insurance cover the cost of an MRI unless your implants were initially covered by insurance (ex. breast reconstruction)
MRI screening for silicone implants
The FDA has put a recommendation out to have implants screened every few years using MRI. The reality is, is that the test is expensive and I do not think that most patients will get it done. I think that most patients will opt for the test if they feel something is wrong.
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That is the recommendation.
The FDA recommends MRI screening to evaluate the silicone implant for intracapsular rupture (this is the most sensitive way if diagnosing rupture). However this is not an absolute necessity. We have learned that silicone implants are safe, even if they do rupture. Many people get a MRI if they feel a change in their breasts, and not just every 2 to 3 years. Do what you feel comfortable with.
Short answer: FDA says YES
The FDA banned silicone breast implants for use in breast augmentation and reintroduced them again in 2006.
Part of the criteria for reintroduction of these implants was the recommendation that patients be screened with MRIs every 3 years. I routinely tell my patients about this statement from the FDA.
However, it is unclear whether your insurance company will pay for the MRI.
If any patient has symptoms that indicate possible rupture, l will order an ultrasound or an MRI depending on the situation. I leave the decision of routine screening upto my patient and do not give them a strong recommendation one way or the other.
This is the FDA recommendation
This is the recommendation made by the FDA, although if this is followed by all patients, there will certainly be a significant false positive rate, leading to many unnecessary surgeries for patients.
I do not recommend routine MRI scans
I do not currently recommend MRI as a screening procedure for silicone gel breast augmentation patients. There is a degree of false positives with a MRI as well as false positives. If there is a clinical indication of an implant rupture then I would consider a MRI scan.
MRI screening is recommended
MRI screening is what the FDA recommends for silicone implants. That said, I do not think that most people are having the screening every 2 to 3 years. If it is really necessary is debatable. The decision is really up to you.
MRI screening an FDA recommendation
The questions are: what are you screening for and why? Of course the main reason is leakage or rupture of the silicone gel implant. Ultrasound and mammograms are not as sensitive, so they can miss intracapsular leaks. MRI is more sensitive so you will miss fewer. However, MRI's can be overly sensitive, and like screening for breast cancer, can indicate abnormalities that are not pathological, both false positive ruptures and incidental glandular abnormalities. This could potentially lead to further tests, biopsies, or major surgery without clear benefit.
Once you diagnose a leakage, what does that mean? What does one do with the MRI results?That is the real problem and point of debate. Some feel that implants need to be removed. Yet there is no demonstrable disease process that is caused by a leaking silicone implant. These so-called "silent leaks" create a decision dilemma since a doctor cannot necessarily say everything is normal but he cannot say what pathology is being treated if he recommends removal and replacement or, if there were to be a patholgy that develops in the future, in whom among those with the silent leaks it will occur.
The real difficulty surgical lies in extracapsular leaks when the gel migrates outside the capsule and then can drift throughout the anatomical region. All extracapsular leaks start as intra capsular leaks but not all intracapsular leaks become extracapsular. Extracapsular leaks obviously need treatment.
Each patient will have different feelings about silent intra-capsular leaks leading to different treatment plans. There is no question you should have regular check-ups with your surgeon or gynecologists experienced with breast implants, but the validity and significance of regular MRI screening should be discussed individually with your plastic surgeon and whether it is prudent to follow the DFA recommendations.
FDA recommends MRI screening
I fully agree with the other post on this question. You have to remember that this is a recommendation by the FDA and necessarily based on surgical judgement. I can not think of any other medical problem or disease that the FDA would recommend an expensive screening test to look for something that will not damage your health.
The decision to follow the FDA recommendation is your choice.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.