Question:

Which group of lymph nodes is most commonly involved in silicone lymphadenopathy as a complication of silicone gel breast implant?
1. Ipsilateral axillary lymph nodes
2. Contralateral axillary lymph nodes
3. Ipsilateral intramammary lymph nodes
4. Ipsilateral supraclavicular lymph nodes
5. Ipsilateral internal mammary lymph nodes





Answer:

The correct answer for the question "Which group of lymph nodes is most commonly involved in silicone lymphadenopathy as a complication of silicone gel breast implant?" is:

1. Ipsilateral axillary lymph nodes



Explanation
1. Silicone lymphadenopathy is a recognized complication of silicone gel implant rupture; the ipsilateral axillary lymph nodes are most commonly involved as this nodal station is primary drainage route for the entire breast.

2-5. While silicone lymphadenopathy has been reported in the ipsilateral intramammary, internal mammary, supraclavicular, and contralateral internal mammary and axillary lymph nodes, the ipsilateral axillary nodes are most likely to be involved,  the likelihood increases in those patients already status post ipsilateral axillary nodal dissections as in those with history of breast cancer.



From the manuscript:
Contralateral Intramammary Silicone Lymphadenitis in a Patient with an Intact Standard Dual-Lumen Breast Implant in the Opposite Reconstructed Breast
Radiology Case. 2013 Nov; 7(11):24-31


This article belongs to the Mamms section.




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From the manuscript

Contralateral Intramammary Silicone Lymphadenitis in a Patient with an Intact Standard Dual-Lumen Breast Implant in the Opposite Reconstructed Breast

Free full text article: Contralateral Intramammary Silicone Lymphadenitis in a Patient with an Intact Standard Dual-Lumen Breast Implant in the Opposite Reconstructed Breast

Abstract
Silicone lymphadenopathy is a recognized complication of silicone gel implant rupture; the ipsilateral axillary lymph nodes are most commonly involved. We report imaging findings on a range of different imaging modalities and biopsy results in a case of biopsy-proven silicone lymphadenitis involving contralateral intramammary and axillary lymph nodes in a patient with an intact standard dual-lumen breast implant in the opposite reconstructed breast. This case demonstrates that in a patient with disrupted lymph drainage due to prior mastectomy and axillary node dissection for breast cancer treatment, silicone particles can migrate in a retrograde fashion via the ipsilateral internal mammary lymph nodes and reach not only the contralateral axilla but also the outer quadrants of the contralateral breast, even in the presence of an intact breast implant.






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