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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Monday, August 22, 2022
Libby R. Copeland-Halperin, MD, of Brigham and Women’s Hospital, Boston, and colleagues observed low adherence to current federal surveillance recommendations for MRI screening in women after silicone implant breast surgery; in fact, the investigators reported only about 6% of such women followed the MRI recommendations. Additionally, women who are unaware of the follow-up imaging guidelines may be at higher risk of asymptomatic implant ruptures several years after surgery. These findings were published in Plastic and Reconstructive Surgery.
“Unfortunately, because routine, asymptomatic follow-up visits several years postoperatively may not be covered by insurance policies, and cosmetic procedures/follow-up are not covered by insurance, many patients may not return for follow-up around the time MRI would be due,” explained Dr. Copeland-Halperin in a press release.
The study authors surveyed patients, via telephone, who had received silicone breast implants between 2011 and 2016. The women were asked about familiarity with the U.S. Food and Drug Administration (FDA) screening recommendations, whether they had undergone follow-up MRI screening, and any barriers to such testing.
Of the 370 patients meeting initial inclusion criteria, 109 patients consented to the survey. Of them, 86 patients had silicone implants placed for breast reconstruction and 23 patients, for breast augmentation. Overall, 17 patients (15.6%) had an MRI at any time after implant placement. Of these patients, 11 also underwent ultrasound or mammography before and/or after the MRI. However, just 5.9% of patients had an MRI within the FDA-recommended timeframe. In contrast, 48.6% of patients surveyed underwent an ultrasound or mammography—most commonly for breast cancer screening and breast pain. Overall, 92 of the 109 patients surveyed reported not being aware of the FDA-recommended follow-up screenings. Additionally, there was no difference in adherence between patients undergoing cosmetic versus reconstructive surgery (P = 1.00), having health insurance (P = .58), or residing in a county with a median annual household income higher than that of the state of residence (P = .33).
Disclosure: The study authors reported no conflicts of interest.
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