Is It Recommended to Get MRI with Saline Breast Implants?

Question

I understand that with silicone implants it is recommended to get an MRI every 3 years or so.  Is this recommended with saline implants as well?

Steven Teitelbaum, MD · Answer

There are two reasons to get an MRI of the breast: to check for rupture of a silicone impant and to check the breast for a cancer not visualized on mammogram or ultrasound.
If a saline implant breaks, it will deflate.  So you will know it will happen without needing to get an MRI.  If a silicone implant breaks, the gel still stays int he breast, so you often won't know.  The MRI is helpful in detecting such a rupture with a silicone implant.
However, the greatest benefit of the MRI is in detecting early breast cancers not seen by mammogram or ultrasound.  While the benefit of detecting a "silent" rupture of a silicone implant has not been shown, earlier detection of breast cancer is a big lifesaver.
MRIs are not yet generally recommended for breast cancer screening of the general population; at this time they are recommended for women who are at high risk or for whom mammograms were equivocal.
Another issue is that mammograms can be obscured in some patients with breast implants, usually if the implants are firm and in front of the muscle.  But an MRI can see around the breast implants.  So if you ever get a mammogram - whether you have saline or silicone implants - and the entire breast isn't clearly seen, then you should discuss with the radiologist whether to get an MRI.
My opinion is that they are so helpful in screening for breast cancer that they should probably be used more commonly for this purpose.  The problem with that is that in their infinite wisdom, most insurers won't pay for breast mris to screen for cancer, leaving the patient to pay for it herself.
This is a big and complex topic, but I hope this helped to answer your question.

John P. Di Saia, MD · Answer

Hello,
Silicone implants can leak without signs that anything is going wrong from the surface of the breast. That is the reason MRIs are recommended to follow the condition of the implants. Saline-filled implants do not have this problem as there is no silicone gel inside them to leak into the patient.

Hisham Seify, MD, PhD, FACS · Answer

No FDA recommendation to use MRI as a diagnostic tool for detection of rupture and other problems in saline implants. When saline implants leak or rupture the clinical effect is very evident. It is a deflated breast on one side. Hope that helps!

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