Silicone breast implants and magnetic resonance imaging screening for rupture: do U.S. Food and Drug Administration recommendations reflect an evidence-based practice approach to patient care?

Abstract

Regular magnetic resonance imaging has been recommended for the purpose of screening for silicone implant rupture. However, when its use as a screening test is critically examined, it appears that evidence to support its use is lacking. For example, there is no conclusive evidence at this time to show that using magnetic resonance imaging screening of asymptomatic women leads to a reduction in patient morbidity. Furthermore, based on existing data, it is unclear whether the potential benefits of screening magnetic resonance imaging tests outweigh the risks and potential costs for the patient. In the face of this uncertainty, shared medical decision making can be recommended. For different women, underlying beliefs and values will sway decision making in different directions. By engaging a woman in the process of shared medical decision making, however, the plastic surgeon and her or his patients can make a mutually agreeable choice that reflects the patient's individual values and health preferences.