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Silicone in the Axilla and Axillary Siliconomas Assessment and Treatment Algorithm

  • Gustavo Emilio SchenoneEmail author
  • Edgardo T. Bernardello
  • Baltasar Eduardo Lema
Chapter

Abstract

Introduction. Lymphadenopathy due to silicone is a very rare side effect of breast enlargement with implants or silicone injection. It is also a benign pathology. The most frequently affected lymph nodes are axillary lymph nodes. The presence of unilateral axillary adenopathy in an adult patient should always generate the suspicion of neoplastic disease, which must be ruled out. The magnitude of the problem will depend on the degree of lymph node infiltration, the number of affected lymph nodes, and the reaction of the tissues that surround them.

Treatment. Decisions pertaining to diagnostic work-up and treatment must be made according to an algorithm designed for that purpose. Eliminating a mammary neoplasm is the first step. Once malignancy has been ruled out, expectant management can be adopted or, if necessary, symptomatic treatment with immunomodulators, but never with surgery at this stage. If, despite medical treatment, painful masses persist, the siliconomas can be removed conservatively. If there is involvement of the brachial or vascular plexus, neurosurgeons and vascular surgeons should be called in.

Conclusions. Silicone lymphadenopathy is a rare complication of medical interventions involving silicone. The axillary lymph nodes are the most frequently affected. The most important differential diagnosis is neoplasm. Fine needle aspiration or an excisional biopsy is indicated. The source of silicone must be evaluated and removed. Symptomatic patients must initially be treated with medical treatment. In principle, axillary silicone is a nonsurgical issue.

Keywords

Silicone Axillary siliconoma Silicone lymphadenopathy Complete axillary lymphadenectomy 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Gustavo Emilio Schenone
    • 1
    Email author
  • Edgardo T. Bernardello
    • 2
    • 3
  • Baltasar Eduardo Lema
    • 4
  1. 1.Plastic Surgery, University of Buenos AiresBuenos AiresArgentina
  2. 2.Faculty of MedicineUniversity of Buenos Aires (UBA)Buenos AiresArgentina
  3. 3.Argentine School of MastologyBuenos AiresArgentina
  4. 4.International Academy of Pathology, UBABuenos AiresArgentina

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