breast implants
Donna Sitrin (where) asks:
>>Does anyone know if among CLIA, CAP and all other regulatory groups (legal,
as well), if there is anthing in written form regarding storage of breast
implants? As hospital coordinator for a pathology group and involved with 7
hospitals, we have retained hundreds of these for many years. Any advice or
information would be appreciated.<<
As a matter of fact, the College of American Pathologists did issue some
fairly detailed recommendations several years ago. I no longer have the
original article, but here's how I abstracted it for my laptop.
Bob Richmond
Samurai Pathologist
Knoxville TN
******************
CAP Recommendations for the handling of prosthetic breast implants, updated
in CAP Today, April 1995, page 58.
Recommend that hospitals have specific procedure-manual policies for handling
prosthetic breast implants. Suggest writing the patient a letter informing
her that the prosthesis will be discarded if she doesn't request it (unless
there is pending litigation). Photography is strongly recommended.
The pathology report should include the weight of the implant, smooth or
textured external surface, number of lumina in the implant, contents (clear
viscous gel/oil/watery liquid. The outer shell is intact and dry/intact but
covered by slippery material/focally ruptured (size of rupture and does gel
run out when you squeeze it?)/completely disrupted with fragmentation of the
outer shell/completely deflated and flat. If only gel is received, search it
for shell fragments. Any inscriptions should be recorded. If there are none,
the "back patch" of the implant should be photographed or described. The
tissue capsule should be weighed, measured (diameter and thickness), inner
surface (smooth/focally calcified/extensively calcified).
Microscopic examination: one or two cassettes of the capsule suffice. Record
presence or absence of inflammation. Describe foreign material. Silicone
appears as refractile, non-birefringent, colorless material, often in
macrophages.
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