Breast Implant Rupture with Lymphatic Silicone Migration: Case Report

Abstract

Silicone breast implant rupture is a recognised late complication, generally diagnosed by imaging modalities. Silicone lymphadenopathy is uncommon, and involvement of the internal mammary nodal chain is rare. We report the case of a 74-year-old woman, asymptomatic and previously treated for invasive ductal carcinoma, in whom routine ultrasound demonstrated features of intra- and extracapsular implant rupture. Magnetic resonance imaging confirmed intracapsular rupture, demonstrating the teardrop sign and the presence of silicone between the implant and the fibrous capsule (subcapsular line). It also revealed extracapsular rupture, with silicone in the adjacent breast parenchyma and in axillary and internal mammary lymph nodes. The patient underwent implant replacement and axillary lymphadenectomy, with a favourable outcome. This case underscores the importance of imaging assessment, even in asymptomatic patients, and highlights the value of a multidisciplinary approach to implant rupture and silicone migration.