Desai Anshumi, Smartz Taylor, Tabibi Orel, Borowsky Peter A, Tadisina Kashyap Komarraju, Singh Devinder P, Kesmodel Susan B, Rojas Kristin E, Mella-Catinchi Juan R
Division of Plastic and Reconstructive Surgery, DeWitt Daughtry Family Department of Surgery, Miami, FL, USA.
University of Miami Miller School of Medicine, Miami, FL, USA.
Aesthetic Plast Surg. 2025 Jan 10. doi: 10.1007/s00266-024-04649-z.
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.
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.
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.
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.
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硅胶性淋巴结病（SL）是乳房植入物的一种并发症，涉及硅胶迁移至附近软组织/淋巴结。关于其临床特征和治疗的数据很少。我们旨在确定SL的临床表现和治疗方法。
利用机构成像系统进行了一项单机构回顾性队列研究，使用搜索词“硅胶性淋巴结病”“硅胶性腺炎”和“硅胶性腺病”来识别SL患者（2016年1月至2023年9月）。从病历中获取患者人口统计学信息、临床特征、影像学检查结果、病理检查及治疗情况。
在52例SL患者中，隆胸占植入手术的90.4%。所有患者均曾在某个时间植入过硅胶假体。相当一部分患者（69.3%）无症状，7.7%有非压痛性淋巴结病，19.2%有疼痛性淋巴结病，1.9%有混合症状。88.7%的病例观察到假体破裂；13.0%为囊内破裂，26.1%为囊外破裂，15.2%两者皆有，45.7%情况不明。腋窝淋巴结最常受累（86.5%），超声检查最常用于检测SL（80.7%）。17.3%的病例进行了活检，所有病例均证实为良性病理。没有患者因SL的治疗而需要手术切除淋巴结。
大多数SL患者无症状，通过观察进行处理。活检和手术干预应保留给那些影像学异常或症状持续的患者。对淋巴结病的评估对于排除有乳腺癌病史患者的恶性肿瘤至关重要。
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