In contrast, nearly half of the women (48.6%) had undergone ultrasound or mammography for various reasons – most commonly for breast cancer screening or breast pain. That included nearly three-fourths of women (73.3%) who later underwent MRI. The researchers note that ultrasound and mammography are less costly than MRI, but less effective in detecting implant rupture.
Of 17 women who had an MRI scan at any time after implant placement, just one cited routine implant surveillance as a reason for scanning. None of the MRI scans detected any abnormality with the implant. Just three of the women who did not undergo MRI were aware of the screening recommendation. They didn't undergo testing because they had no concerns about their implants or they "didn't like MRIs."
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The study finds low rates of awareness and adherence to the recommendation to undergo routine MRI screening after breast silicone implant placement. "Whether MRI is the optimal imaging modality, uncertainty about its clinical utility, and concerns about the economic cost of the FDA recommendation are topics of debate, and many plastic surgeons do not agree with the recommendation," the researchers write.
In 2020, the FDA changed its surveillance recommendations to include ultrasound or MRI beginning 5 to 6 years after silicone implant placement and every 2 to 3 years thereafter. "Because our study was initiated before this change, we examined patient awareness of and adherence to the prior recommendations," Dr. Copeland-Halperin comments. "It is possible that the new guidelines may improve patient adherence, though further studies are needed to determine this. Similarly, the perception of the guidelines among plastic surgeons may also have changed with the updated recommendations."
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