Effect of breast implants on mammography.

We developed an experimental, reproducible method of evaluating the radiographic characteristics of breast implants in vitro using a mammographic phantom and a cadaver. Implant shells tested included smooth silicone, textured silicone, and silicone coated with polyurethane foam. Each type of shell was subsequently filled with saline, silicone gel, and peanut oil; the images were recorded radiographically. Textured silicone and smooth silicone shells minimally impair detection of artifacts. Polyurethane-coated shells are less radiolucent but allow visualization of some microcalcifications. Saline and silicone-gel-filled implants are radiopaque regardless of shell type. Textured silicone and smooth silicone shells filled with peanut oil are radiolucent and allow visualization of microcalcifications and most soft-tissue masses. These data demonstrate that radiolucent breast implants are possible, and further efforts are under way to achieve Food and Drug Administration approval for clinical testing.