Fig. 6.

A 54-year-old transgender woman is referred for a screening mammography prior to nipple sparing mastectomy to remove painful masses caused by free silicone. a Tomosynthesis shows bilateral large dense masses which are inseparable from the pectoralis muscle (arrows). There are also innumerable small silicone granulomas. b Ultrasound shows an example of the indistinct hyperechoic “snow storm” appearance of free silicone at posterior depth in both breasts (arrows). c Post-contrast subtracted MRI image shows no suspicious enhancing mass