Silicone implants--a possible confounder for urinary platinum background concentrations?

INTRODUCTION

Urinary platinum excretion from occupationally unexposed population is very low. Up to now, in Germany, dental noble metal alloys and a platinum based chemotherapy have been identified as reason for elevated urine concentrations. As fabrication of silicone involves platinum as catalyst, this study examines the potential release of platinum from silicone breast implants by quantifying urinary platinum concentration.

METHODS AND RESULTS

Platinum release from three different types of silicone implants into saline solution was measured in a laboratory experiment. It showed a strong increase of platinum concentration during the first 30 min and high platinum concentrations even after 60 h. In the following field study urinary platinum concentrations were determined from 30 women with dental gold alloy restorations and 28 women without such dental inlays. Median platinum concentrations were 5.2 ng/l urine (21.2 ng/g creatinine) for the women with dental gold inlays and 6.0 ng/l urine (5.4 ng/g creatinine) for those without. Compared with the urinary platinum concentrations provided by the German Environmental Survey (GerES) for the general female population the urinary platinum levels of women with silicone implants of the presented study were significantly higher, both for the study groups with and without dental gold alloy inlays.

CONCLUSIONS

Silicone breast implants must be considered as a new confounder and as a further contributor to elevated urinary platinum concentrations in human platinum background reference values of women.

Comparison of dynamic MR imaging of the breast and sestamibi scintimammography for evaluation of indeterminate mammographic lesions

The aim of this study was to compare Tc-99m sestamibi scintimammography and dynamic contrast-enhanced MR imaging for the evaluation of indeterminate mammographic lesions. Forty patients with questionable mammographic findings were included in a prospective study. Thirty lesions were non-palpable. Mean lesion size was 1.6+/-0.7 cm (range 0.5-3.5 cm). Scintigraphy was considered as malignant when focal tracer accumulation was present. In MR imaging, lesions were classified according to their signal intensity time course: no enhancement or steady enhancement with low signal intensity (M0); steady enhancement with high signal intensity (M1); or rapid enhancement with plateau (M2) or washout (M3). Lesions classified as M2 or M3 were considered as suspicious for malignancy. Histopathologic evaluation was performed in 24 lesions. In 16 cases lesions were classified as benign from follow-up examinations (mean 24 months). Malignancies were proven in 14 patients (9 invasive carcinomas, 5 ductal carcinoma in situ). Sensitivity of MR imaging was 12 of 14 (86%) and sensitivity of scintimammography was 8 of 14 (57%). One of 26 benign lesions was false positive at MR imaging. Scintigraphy showed no false-positive results. In conclusion, magnetic resonance imaging provided high accuracy in evaluation of indeterminate mammographic lesions. Sensitivity of scintimammography was too low in detecting small carcinomas.

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