What is a prosthesis control unit?

What resources should a breast prosthesis control unit have?

A prosthesis control unit requires the participation of different specialists and techniques, so ideally it should be located in a first-rate hospital center that guarantees access to these resources.

The necessary resources for a breast prosthesis control unit are:

1. A specialist in Plastic and Aesthetic Surgery with extensive experience in breast surgery
2. A radiologist with experience in interpreting breast resonance
3. A state-of-the-art MRI equipment.
4. A breast coil for use in the MRI scan

Why do I need to have a reference unit in my tracking?

In assessing the review, it is relevant to know the patient’s history and the Magnetic Resonance or other images that have been previously obtained to identify possible variations. Therefore, having a reference unit in which they can have our medical history and previous images facilitates follow-up.

Can they perform this control in the gynecological review?

The annual review is oriented to the identification of gynecological problems or risks but does not contemplate the necessary tests for the control of prosthetic breakage. Breast ultrasound commonly used to control breast cancer in patients with prostheses is not reliable for the identification of ruptures. Similarly, the revision of the prosthesis is not a substitute for the gynecological revision.

What is the Magnetic Nuclear Resonance test?

Magnetic resonance imaging is a safe imaging test because it does not use radiation. It is especially sensitive to liquids, making it ideal for identifying the expansion of the filling of the prosthesis outside the implant area and for early detection of breaks that are in the intracapsular phase, that is, before the silicone content has out of the capsule.

What is the Lingüini sign?

The typical image displayed on a silicone prosthetic tear is called the Lingüini sign. The implant membrane is like a bag containing the silicone gel padding. When the membrane breaks, this cover folds, losing its shape, and is visualized in the resonance test with a very typical image reminiscent of Italian pasta in the form of small tongues called Lingüini. Hence the name of the sign that identifies the breakage of the prosthesis. In any case, this sign is not the only one that must be taken into account for the diagnosis and the evaluation of the images requires interpretation by a specialized breast radiologist with experience in this type of case.

Which test is more suitable for the diagnosis of rupture?

When we carry out a test to reach a diagnosis, we must take into account the sensitivity and specificity of the test. The sensitivity is in that% of patients who have the pathology that test is able to detect it. If a test is insensitive, there will be many patients that we will not detect. The specificity is that% of patients that the test identifies as positive actually have this pathology. A little specific test will give us many false positives that will be patients who do not really have the disease.

Below we can see the sensitivity and specificity of the different tests that we can perform.

Resonance is the most sensitive test for the identification of breaks, since it manages to identify 95% of the breaks, while ultrasound only does so in 59% of cases and mammography in 23%. However, the resonance offers 2 and 5% false positives; that means that in those cases it identifies that there is a break when in fact it does not exist. Therefore, in case of diagnosing a rupture by means of resonance, another complementary test may be useful if the plastic surgeon and the radiologist consider it appropriate. It is also important that the MRI unit used is equipped for specific breast tests and has a specialized radiologist with experience in the breast.