The most pressing problem is differentiating between mammary siliconomas and breast cancer. Performing thorough physical examinations of the breast, as well as mammography, breast ultrasound and magnetic resonance imaging, is virtually impossible. Consequently, early detection of breast cancer can be seriously delayed in these patients.
Patients usually present with hardened breasts, breast nodules or indurated masses that mimic advanced breast cancer. Such complex scenarios give rise to several tough questions: How should surgeons act? What do, and should such patients expect? How can breast cancer be definitively ruled out? Does such a situation indicate the immediate need for surgery, or can some patients be monitored? Should surgery be conservative or radical? Should sentinel nodes be investigated? How should axillary siliconomas be managed? Should patients be left surgically untreated if they refuse surgery? The contributions of the many experts who have worked with me on this have allowed us to provide a thorough, updated view of the problems that can result from silicone breast injections, and informed suggestions about how to overcome them.