Presentation
A 50 year old woman, who had undergone augmentation mammoplasty when she was 30, was routinely examined in the breast clinic. Clinical examination demonstrated a small, mobile nodule in in the upper central quadrant of the right breast.
Patient Data
Breast ultrasounds show an hypoechoic, not homogeneous, avascular round nodule of 10 mm, with indistinct margins and without posterior acoustic shadowing.
The implant shell is visualized as a thin and continuous echogenic line at the muscle-implant interface.
Core needle biopsy of the nodule showed a invasive ductal carcinoma (B5).
A lumpectomy by a periareolar incision, without opening the capsule of the implant, and a sentinel node biopsy was performed. The tumor was grade G2 stage pT1b (10 mm) pNmi (sn) M0, estrogen and progesterone receptors positive and HER2/neu- negative.
Case Discussion
The risk of breast cancers in women undergoing breast augmentation is not increased; indeed the epidemiological observations show a lower incidence of breast cancer in augmented women, probably related to a reduced amount of glandular tissue (this hypothesis has not been confirmed).
Breast sonography, after a clinical examination, can be a simple and helpful tool in cancer detection in augmented women; it must be followed by contrast-enhanced MRI (especially for suspicion masses), FNA or core biopsy.
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