Intracapsular Silicone Breast Implant Rupture Presenting as Axillary Lymphadenopathy: A Case Report

Silicone breast implants are widely used for cosmetic and reconstructive purposes. Despite being designed to reduce complications, they can rupture silently and occasionally present with atypical findings such as axillary lymphadenopathy. We report the case of a 40-year-old woman who underwent bilateral augmentation mammoplasty in 2016 and presented nine years later with a painless, slowly enlarging right axillary lump. Examination revealed firm nodes and mild breast contour distortion. Mammography showed bilateral retroglandular implants with enlarged right axillary nodes. MRI confirmed rupture with characteristic “subcapsular line” sign and “keyhole” sign, without evidence of extracapsular spread. Ultrasound-guided Fine-Needle Aspiration Cytology (FNAC) revealed features consistent with a silicone-induced foreign body reaction. Surgical management included bilateral implant removal with total capsulectomy and excision of enlarged right axillary lymph nodes with intraoperative confirmation of right implant rupture. This case illustrates characteristic imaging features, along with histopathological correlation, both of which are essential for accurate diagnosis and timely management.