Breast infection and "metal artifact" 2.5 years post-op

Hi littlemmi:

I am sorry to hear this. I did not have reconstruction, and anyway have no knowledge about the materials, methods, and instruments used, but agree it seems suspicious in that it is seen in one breast only.

Was the MRI that found the "metal artifact" performed at the same institution that performed your surgery 2.5 years ago? (Because if it were some sort of error, they may be less forthcoming due to concerns about liability.)

BarredOwl

Hi:

Such clips have characteristic shapes and dimensions. Perhaps naively, I was thinking that the radiologist would use the term of art "clip" rather than "metal artifact", if that is what was actually seen.

In your inquiries, you may wish to inquire: What are the dimensions of the "metal artifact" observed? Is it consistent with such a clip or not?

I was under the impression that the artifact was in the breast, not the axilla, but perhaps I over-interpreted the description. In some procedures, clinically suspicious axillary nodes that are biopsied pre-surgery are marked by a clip to enable later removal in case the pathology shows malignancy. Such a marker may be left behind if the node biopsy result is benign (and the node is not later determined to be a sentinel node during SNB).

In some axillary staging procedures (e.g., with prophylactic mastectomy), sentinel node(s) are mapped and marked with clip(s), but not removed unless invasive disease is found upon surgical pathology. If no invasive disease is found, the node(s) would be left in place, along with the clip(s). These would usually be located in/near the axilla.

In contrast, during routine SNB concurrent with mastectomy, the sentinel nodes are removed upon identification. To my knowledge (and I could be wrong), the site of SNB removal (usually in the axilla) is not routinely marked. I was under the impression that if further axillary clearance were needed, it is not targeted by pre-placed marker(s).

Surgical clips are also used during biopsies to mark the site of biopsy in the breast. A clip placed at a site found to be benign would not need to be removed. However, with bilateral mastectomy one would ordinarily expect all such markers to be removed (whether the biopsy was proven malignant or benign). My surgical pathology report refers to "silver metallic clips" present in the tissue removed.

If you know that clips were placed during any procedure you had, you can check your surgical pathology report from bmx to see if they are mentioned and accounted for. Rarely, clip migration is observed, so it might theoretically be possible that a migrated clip was left behind in bmx. Please continue to inquire until you receive answers to your satisfaction.

BarredOwl