Presentation and Management of Silicone Lymphadenopathy: A Single Institutional Retrospective Cohort Study.

IF 2 3区医学 Q2 SURGERY Aesthetic Plastic Surgery Pub Date : 2025-01-10 DOI:10.1007/s00266-024-04649-z

Anshumi Desai, Taylor Smartz, Orel Tabibi, Peter A Borowsky, Kashyap Komarraju Tadisina, Devinder P Singh, Susan B Kesmodel, Kristin E Rojas, Juan R Mella-Catinchi

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Abstract

Introduction: Silicone Lymphadenopathy (SL) is a complication of breast implants that involves migration of silicone to nearby soft tissue/lymph nodes. Data on its clinical features and management is scarce. We aimed to identify the clinical presentation and management of SL.

Methods: A single-institution retrospective cohort study was conducted from our institutional imaging system where search terms "Silicone lymphadenopathy", "silicone adenitis" and "silicone adenopathy" were used to identify patients with SL (January 2016-September 2023). Patient demographics, clinical features, imaging findings, pathological investigation, and treatment were obtained from the medical records.

Results: Of 52 patients with SL, breast augmentation accounted for 90.4% of the implant placements. All patients had silicone implants placed at some time. A significant portion of patients (69.3%) were asymptomatic, while 7.7% had non-tender lymphadenopathy, 19.2% experienced painful lymphadenopathy, and 1.9% presented with mixed symptoms. Implant rupture was observed in 88.7% of cases; 13.0% intracapsular, 26.1% extracapsular, 15.2% both, and unknown in 45.7%. Axillary nodes were the most commonly involved (86.5%), and ultrasonography was most commonly used to detect SL (80.7%). Biopsy was performed in 17.3% of cases, confirming benign pathology in all cases. No patients required surgical excision of lymph nodes for management of SL.

Conclusion: Most patients with SL are asymptomatic and are managed with observation. Biopsy and surgical intervention should be reserved for those patients with abnormal imaging or persistent symptoms. Evaluation of lymphadenopathy is essential to exclude malignancy in patients with a history of breast cancer.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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硅胶淋巴结病的表现和治疗：一项单一机构回顾性队列研究。

简介：硅胶淋巴结病（SL）是乳房植入物的并发症，涉及硅胶迁移到附近的软组织/淋巴结。关于其临床特征和治疗的资料很少。方法：在我们的机构成像系统中进行了一项单机构回顾性队列研究，使用搜索词“硅胶淋巴结病”、“硅胶腺炎”和“硅胶腺病”来识别SL患者（2016年1月- 2023年9月）。从医疗记录中获得患者的人口统计、临床特征、影像学表现、病理调查和治疗。结果：在52例SL患者中，隆胸占植入物放置的90.4%。所有患者都在某个时间植入了硅胶。相当一部分患者（69.3%）无症状，其中7.7%为无压痛性淋巴结病，19.2%为疼痛性淋巴结病，1.9%为混合性症状。88.7%的病例出现种植体破裂；13.0%囊内，26.1%囊外，15.2%两者都有，45.7%未知。腋窝淋巴结最常受累（86.5%），超声检查最常发现SL（80.7%）。17.3%的病例行活检，所有病例病理均为良性。结论：大多数SL患者无症状，可通过观察治疗。对于那些有异常影像或持续症状的患者，应保留活检和手术干预。对于有乳腺癌病史的患者，淋巴结病变的评估对于排除恶性肿瘤至关重要。证据等级iii：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明www.springer.com/00266。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Aesthetic Plastic Surgery 医学-外科

CiteScore

4.40

自引率

25.00%

发文量

479

审稿时长

3 months

期刊介绍： Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP). Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships. Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.