Implants, Male Breast Disease

Question 1

implant types; placement

Answer 1

saline: valve that allows filling; wall of implant denser than center due to silicone elastomer
silicone: premanufactured sizes; uniform density

retropectoal or prepectoral/retroglandular

Question 2

fibrous capsule

Answer 2

forms as a reaction to foreign body; may calcify

implant may herniate through capsule and cause deformity over time

Question 3

Eklund view

Answer 3

implant displaced mammography view

Question 4

implant rupture types

Answer 4

intracapsular rupture or extracapsular rupture

most important distinction for silicone implants

saline rupture will be evident clinically due to resorption

Question 5

silicone implant rupture

Answer 5

intracapsular: linguine sign on MRI
extracapsular: high density silicone extends beyond capsule into breast tissue; snowstorm sign

Question 6

reduction mammoplasty

Answer 6

reduce back pain/aesthetic reasons

remove parenchyma/skin from inferior breast and relocate nipple superiorly

Question 7

mammographic findings of reduction mammoplasty

Answer 7

skin thickening in lower breast; curvilinear architectural distortion, fat necrosis

Question 8

gynecomastia

Answer 8

development of glandular tissue in male; subareolar palpable abnormality

Question 9

causes of gynecomastia

Answer 9

cirrhosis, drugs (antihypertensives, antidepressants), MJ, pituitary hormone dysfunction, hormone producing tumors

Question 10

gynecomastia findings

Answer 10

mammo: flame shaped/triangular subareolar density

Question 11

male breast cancer

Answer 11

men >60, palpable mass

spiculated mass; but any breast mass in a male should be regarded with suspicion