Macrolane and breast diagnostics

Macrolane is a gel that is used for body contouring, e. g. breast augmentation. It is CE marked as a medical device in Europe since September 2007.

At Stureplanskliniken we have done a lot of Macrolane treatments during the last years, especially breast augmentations. A lot of our patients have done mammograms and ultrasound after treatment.  Since Macrolane is not injected into the breast gland but underneath it, it is usually not difficult to examine the breast gland after treatment, but in some cases mammograms have to be completed with ultrasound. However, it is important that our patients inform the radiologist that they have done Macrolane treatment when they come for mammography.

Macrolane consists of 98% water and 2% hyaluronic acid, a long-chain sugar. In mammograms, Macrolane is seen as a soft grey shadow, resembling water. In ultrasound, Macrolane gives a dark echo resembling water, but also, according to radiologist Magnus Tengvar at Sophiahemmet, a typical “snow flake” phenomenon specific for Macrolane.

Macrolane is a relatively new treatment that has been on the market for about two and a half years. Just like when silicone implants were introduced, it will take some time before all radiologists have personal experience with Macrolane. For us who offer treatments with Macrolane, it is important that we give clear information not only to our patients but also to medical collegues in the hospitals, and that we are available for questions.

One of the most important methods to discover breast tumors is self examination of the breasts. At Stureplanskliniken we give our patients ”home work” to examine the breasts before Macrolane treatment and after treatment they get to examine the breasts again. It is our experience that most patients find it easy to examine the breasts and that they get to recognize their Macrolane after treatment.

Before Macrolane treatment we recommend patient above 40 years of age to have a recent mammogram and for patients 30 to 40 we recommend them to do mammogram or ultrasound before treatment. After treatment we recommend patients to take part in normal breast screening. We do not recommend Macrolane for patients with a history of benign cysts or other changes in the breasts requiring regular mammographic controls, and we do not recommend Macrolane if there is a high hereditary risk of breast cancer.

It is known that all kinds of breast implants may interfere with the interpretation of mammograms, but in contrast to silicone implants that are radiopaque, Macrolane is translucent on x-ray. Sometimes complimentary ultrasound may be needed.

As a patient at Stureplanskliniken you are always welcome to phone or visit if you have any concerns or if you want an examination. We also have contacts with experienced radiologists if mammography or ultrasound is needed.

Pyra Haglund, MD, PhD.

Medical officer at Stureplanskliniken Stockholm, Göteborg and Malmö.