Silicone breast implant rupture mimicking inflammatory breast cancer: A case report

Silicone breast implant rupture is a recognized long-term complication that may result in extracapsular silicone deposition and foreign-body granulomatous inflammation, potentially mimicking breast malignancy. We report a 74-year-old woman with breast augmentation approximately 30 years earlier who presented with failure to thrive and progressive left breast erythema despite multiple courses of antibiotics. Mammography demonstrated findings suggesting implant rupture with extensive free silicone in the left breast. Given associated skin thickening and persistent inflammation, the findings were interpreted as BI-RADS 4 and inflammatory breast cancer could not be excluded. Punch biopsy revealed dermal inflammation, foreign-body giant-cell reaction, and material consistent with silicone, without malignancy, confirming silicone-associated granulomatous inflammation. The patient’s condition continued to decline requiring intensive care unit admission and subsequently expired 2 months after index presentation and admission. We report this case to highlight extracapsular silicone rupture as an important mimic of inflammatory breast cancer and emphasizes the role of multimodality imaging and tissue sampling in establishing the diagnosis while distinguishing localized siliconosis from systemic breast implant-related syndromes.