Association Between Mastalgia and Elastographic Breast Stiffness in Patients with Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study

Deniz Esin Tekcan Şanlı; Ahmet Necati Şanlı; Duzgun Yıldırım

doi:10.31067/acusaglik.1544229

EN

Association Between Mastalgia and Elastographic Breast Stiffness in Patients with Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study

Abstract

Purpose: In this study, it was aimed to evaluate the long-term effect of silicone implants on elastographic breast stiffness and the relationship between breast stiffness and mastalgia in cases with subpectoral silicone implants. Materials and Methods: Cases with subpectoral silicone implants at least one year after surgery as the patient group (Group 1) and cases without silicone implants as the control group (Group 2) were included in the study. Shear wave velocity values (Vmean, Vmax, Vmin, Vsd) were measured by multiparametric shear wave elastography (mpSWE). All cases were asked to rate their mastalgia (Mastalgia Score, MS) using a verbal numerical rating scale (NRS, 0-10). The relationship between age, parity, mammographic breast density, menopausal status, mastalgia score, and elastographic breast stiffness was evaluated in each group. Results: All mpSWE values in Group 1 were higher than in Group 2 (p<0.05). Mean breast parenchymal stiffness (Vmean) was significantly lower in women under 40 years of age than in women over 40, and in women who had not given birth than who had given birth (p<0.05). MS was significantly higher in women with dense breast structure (p<0.05). However, no significant difference was found between MS and other variables (age, parity, menopausal status, silicone implants). Conclusion: Subpectoral silicone breast implants are associated with increased breast stiffness as measured quantitatively by elastography. However, no statistically significant relationship was found between elastographic breast stiffness and mastalgia in the long-term post-implantation period. Therefore, factors other than implants should be considered in cases of chronic post-implant mastalgia.

Keywords

References

1. Chao AH, Garza R 3rd, Povoski SP (2016) A review of the use of silicone implants in breast surgery. Expert Rev Med Devices. 13(2):143-156. https://doi.org/10.1586/17434440.2016.1134310.
2. Nava MB, Rancati A, Angrigiani C, Catanuto G, Rocco N (2017) How to prevent complications in breast augmentation. Gland Surg. 6(2):210-217. https://doi.org/10.21037/gs.2017.04.02
3. Morrow M. The evaluation of common breast problems (2000) Am Fam Physician. 61(8):2371-8
4. Eren T, Aslan A, Ozemir IA, Baysal H, Sagiroglu J, Ekinci O, et al (2016) Factors Effecting Mastalgia. Breast Care (Basel). 11(3):188-193. https://doi.org/10.1159/000444359
5. Bolat H, Aşcı Ö, Kocaöz S, Kocaöz S (2022) Noncyclical and cyclical mastalgia in Turkish women: Prevalence, risk factors, health-care seeking and quality of life. Health Care Women Int. 43(1-3):160-175. https://doi.org/10.1080/07399332.2021.1887194.
6. Rosolowich V, Saettler E, Szuck B (2006) Breast Dısease Commıttee. Mastalgia. J Obstet Gynaecol Can. 28(1):49-57. https://doi. org/10.1016/S1701-2163(16)32027-8
7. Han H, Cha YM, Yang JH, Song EH, Hwang HY, Chung HS, et al (1993) Fibrocystic disease of breast: variable mammographic and sonography appearance. J Korean Soc Med Ultrasound. 12:216-222.
8. Román M, Louro J, Posso M, Alcántara R, Peñalva L, Sala M, et al (2021) Breast density, benign breast disease, and risk of breast cancer over time. Eur Radiol. 31(7):4839–4847. https://doi.org/10.1007/ s00330-020-07490-5.

9. Warren R, Skinner J, Sala E, Denton E, Dowsett M, Folkerd E, et al (2006) Associations among mammographic density, circulating sex hormones, and polymorphisms in sex hormone metabolism genes in postmenopausal women. Cancer Epidemiol Biomarkers Prev. 15(8):1502-1508. https://doi.org/10.1158/1055-9965.EPI-05-0828.
10. Boyd NF, Li Q, Melnichouk O, Huszti E, Martin LJ, Gunasekara A, et al (2014) Evidence that breast tissue stiffness is associated with risk of breast cancer. PLoS One. 9(7):e100937. https://doi.org/10.1371/ journal.pone.0100937
11. Boyd NF, Li Q, Melnichouk O, Huszti E, Martin LJ, Gunasekara A, et al (2002) A longitudinal study of the effects of menopause on mammographic features. Cancer Epidemiol Biomarkers Prev. 11:1048-1053
12. Gram IT, Funkhouser E, Tabár L (1997) The Tabár classification of mammographic parenchymal patterns. Eur J Radiol. 24(2):131-136. https://doi.org/10.1016/s0720-048x(96)01138-2.
13. Rzymski P, Kubasik M, Gaca M, Opala T (2011) Is the shear wave sonographic elastography correlated with pain after breast augmentation with silicone implants an indication of inflammatory activity? A preliminary report. Wideochir Inne Tech Maloinwazyjne. 6(4):217-225. https://doi.org/10.5114/wiitm.2011.26255.
14. Dzoic Dominkovic M, Ivanac G, Bojanic K, Kralik K, Smolic M, Divjak E, et al (2020) Exploring Association of Breast Pain, Pregnancy, and Body Mass Index with Breast Tissue Elasticity in Healthy Women: Glandular and Fat Differences. Diagnostics (Basel). 10(10):393. https://doi.org/10.3390/diagnostics10060393.
15. Urits I, Lavin C, Patel M, Maganty N, Jacobson X, Ngo AL, et al (2020) Chronic Pain Following Cosmetic Breast Surgery: A Comprehensive Review. Pain Ther. 9(1):71-82. https://doi.org/10.1007/ s40122-020-00150-y
16. Wallace MS, Wallace AM, Lee J, Dobke MK (1996) Pain after breast surgery: a survey of 282 women. Pain. 66(2-3):195-205. https://doi. org/10.1016/0304-3959(96)03064-3.
17. Gabriel A, Maxwell GP (2019) Implant selection in the setting of prepectoral breast reconstruction. Gland Surg. 8(1):36-42. https:// doi.org/10.21037/gs.2018.11.09
18. Bae JY, Shin HY, Song SY, Lee DW (2021) Risk and protective factors affecting sensory recovery after breast reconstruction. Arch Plast Surg. 48(1):26-32. https://doi.org/10.5999/aps.2020.01151.
19. Patel BC, Wong CS, Wright T, Schaffner AD (2021) Breast Implants. In: StatPearls (Internet). Treasure Island (FL): StatPearls Publishing.
20. Wyatt LE, Sinow JD, Wollman JS, Sami DA, Miller TA (1998) The influence of time on human breast capsule histology: smooth and textured silicone-surfaced implants. Plast Reconstr Surg. 102(6):1922 1931. https://doi.org/10.1097/00006534-199811000-00017.
21. Luke JL, Kalasinsky VF, Turnicky RP, Centeno JA, Johnson FB, Mullick FG (1997) Pathological and biophysical findings associated with silicone breast implants: a study of capsular tissues from 86 cases. Plast Reconstr Surg. 100(6):1558-1565.

Details

Primary Language

English

Subjects

Radiology and Organ Imaging

Journal Section

Research Article

Authors

Deniz Esin Tekcan Şanlı ^*
0000-0002-6545-5757
Türkiye

Ahmet Necati Şanlı
0000-0002-1483-8176
Türkiye

Duzgun Yıldırım
0000-0002-5411-229X
Türkiye

Publication Date

May 18, 2026

Submission Date

September 6, 2024

Acceptance Date

May 3, 2026

Published in Issue

Year 2026 Volume: 17 Number: April, May, June 2026

DOI

https://doi.org/10.31067/acusaglik.1544229

IZ

https://izlik.org/JA49JJ67LY

Cite

RIS / Bibtex

APA

Tekcan Şanlı, D. E., Şanlı, A. N., & Yıldırım, D. (2026). Association Between Mastalgia and Elastographic Breast Stiffness in Patients with Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 17(April, May, June 2026). https://doi.org/10.31067/acusaglik.1544229

AMA

1.Tekcan Şanlı DE, Şanlı AN, Yıldırım D. Association Between Mastalgia and Elastographic Breast Stiffness in Patients with Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study. Acibadem Univ Saglik Bilim Derg. 2026;17(April, May, June 2026). doi:10.31067/acusaglik.1544229

Chicago

Tekcan Şanlı, Deniz Esin, Ahmet Necati Şanlı, and Duzgun Yıldırım. 2026. “Association Between Mastalgia and Elastographic Breast Stiffness in Patients With Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 (April, May, June 2026). https://doi.org/10.31067/acusaglik.1544229.

EndNote

Tekcan Şanlı DE, Şanlı AN, Yıldırım D (May 1, 2026) Association Between Mastalgia and Elastographic Breast Stiffness in Patients with Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17 April, May, June 2026

IEEE

[1]D. E. Tekcan Şanlı, A. N. Şanlı, and D. Yıldırım, “Association Between Mastalgia and Elastographic Breast Stiffness in Patients with Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study”, Acibadem Univ Saglik Bilim Derg, vol. 17, no. April, May, June 2026, May 2026, doi: 10.31067/acusaglik.1544229.

ISNAD

Tekcan Şanlı, Deniz Esin - Şanlı, Ahmet Necati - Yıldırım, Duzgun. “Association Between Mastalgia and Elastographic Breast Stiffness in Patients With Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 17/April, May, June 2026 (May 1, 2026). https://doi.org/10.31067/acusaglik.1544229.

JAMA

1.Tekcan Şanlı DE, Şanlı AN, Yıldırım D. Association Between Mastalgia and Elastographic Breast Stiffness in Patients with Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study. Acibadem Univ Saglik Bilim Derg. 2026;17. doi:10.31067/acusaglik.1544229.

MLA

Tekcan Şanlı, Deniz Esin, et al. “Association Between Mastalgia and Elastographic Breast Stiffness in Patients With Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, vol. 17, no. April, May, June 2026, May 2026, doi:10.31067/acusaglik.1544229.

Vancouver

1.Deniz Esin Tekcan Şanlı, Ahmet Necati Şanlı, Duzgun Yıldırım. Association Between Mastalgia and Elastographic Breast Stiffness in Patients with Subpectoral Silicone Implants: A Multiparametric Shear Wave Elastography Study. Acibadem Univ Saglik Bilim Derg. 2026 May 1;17(April, May, June 2026). doi:10.31067/acusaglik.1544229