2005 Papers - Helsel


CPT Bryan Helsel, MD, Department of Surgery, Tripler Army Medical Center

Objective: After silicone injections, patients often present with multiple breast masses and associated complications. Current diagnostic modalities are inadequate to detect an underlying carcinoma. Many of these women will need to undergo a mastectomy with some form of reconstruction in order to address these issues. We describe our surgical approach to these patients.

Methods: Women who underwent mastectomy between 1 July 1988 and 31May 2004 were identified through our surgery scheduling database. Additionally, the inpatient charts of patients having a form of mastectomy or reconstructive breast surgery as identified via CPT codes and ICDM coding were reviewed. Patient demographic as well as surgical information was recorded on a standardized sheet.

Results: Five patients underwent breast surgery following silicone injections. They ranged in age from 43 to 63. Their most common presenting complaint were concern for cancer (5/5) followed by masses(4/5), mastodynia(3/5), and skin changes(2/5). Physical exam reveled mastitis(2/5), dermatitis(1/5), masses(5/5), and skin dimpling(1/5). All patients underwent preoperative mammography with two interpreted as unable to rule out carcinoma. All specimens showed evidence of chronic inflammation with granulation formation without evidence of malignancy.<

Conclusion: Patients who previously had silicone breast injections may need mastectomy with reconstruction due to complications associated with the injections as well as the inability to detect an underlying carcinoma. Utilizing a variety of surgical and reconstructive techniques, surgery can be performed to address their presenting complaints and provide an acceptable cosmetic result.

The views expressed in this abstract/manuscript are those of the author(s) and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the U.S. Government.