CSP Team Note: This awesome post is a collaboration between our partners at Charlotte Radiology and Hunstad/Kortesis Plastic Surgery + MedSpa (HK). A huge thanks to Dr. Gaurav Bharti, Hunstad Kortesis Plastic Surgery, and Dr. Deborah Agisim, Charlotte Radiology for their knowledge and insight. Great info here!
Women who are considering breast augmentation surgery or who have already had breast implants, might question whether mammograms are still the right way to screen for cancer. Studies show that mammograms ARE still an effective way to screen women with breast implants for breast cancer, and breast cancer screening guidelines are the same for women with and without breast implants. Here are some Smarty tips for women on maintaing good breast health for women with breast implants:
What you need to know BEFORE getting implants
If you’re over 35 years old, we recommend getting mammograms BEFORE the breast augmentation surgery to serve as a baseline. After breast augmentation, patients can get a mammogram 6-12 months after the procedure. We would sometimes recommend a mammogram to a woman before the age of 35 if she is considered high risk.
What to know AFTER getting implants
Once you have implants, the process of getting a mammogram with breast implants will be quite different. When breast implants are present, it can make it more difficult to detect breast cancer on a mammogram because the implants can hide some breast tissue and block areas of concern. Because of this, standard techniques used in mammography for compression of the breast are not as effective for women with breast implants and more views of the breasts will be taken to ensure optimal examination of the tissue.
The overall look of the breast with an implant above or below the muscle will be subtly different. More breasts are imaged with implants behind the muscle. To better view breasts with a mammogram, a modified Eklund view is performed, which displaces the implant away from the breast to better visualize breast tissue. Here are some pictures to better illustrate:
Tips for scheduling a successful mammogram
Whether you have saline breast implants or silicone breast implants, your mammogram can be very successful. However, there are certain things you should keep in mind and certain steps you should take to have the best experience possible:
1. Find a mammography facility that has experience dealing with women who have breast implants. You will benefit both from a technician who has experience conducting mammograms on women with breast implants and from a radiologist who has experienced reading the sometimes-tricky images that breast implants can produce.
2. When you schedule your appointment, inform the facility that you have implants so the staff can allot more time to perform additional imaging of the breast tissue and can have the appropriate staff working with you.
3. Ensure the facility you schedule with plans to take implant displacement views of your breasts, which involves moving the implant out of the image to get a better view of the breast tissue.
The Good News
– Even though mammograms may be more difficult to perform and read for women with breast implants, they are still considered very effective in detecting cancer.
– Implants have not been shown to increase breast cancer risk, and although mammography does not detect cancer as well in women with implants, this doesn’t appear to result in more advanced cancers at diagnosis. Research shows that both women with and without implants were diagnosed with cancers of a similar size and stage.
– Research has also shown that mammography results don’t reveal any more false positives for women with breast implants than for women without breast implants.
The Not-So-Good News
– Getting a mammogram with breast implants will likely take longer, may cost you more if additional testing is needed, and could expose you to slightly more radiation if extra images are needed.
– Some research shows that mammograms performed on women with breast implants can miss tumors. In some cases it might recommended to use other screening tools, such as magnetic resonance imaging (MRI) or ultrasound. These tools can be particularly valuable as second-line tests after mammography for cases when very little tissue can be included in the mammogram or when a suspicious area shows up on the mammogram.
– There is an extremely small chance that your implants could rupture during a mammogram. While this is not a common occurrence, it has been known to happen. You can take precautionary measures by working with a mammography technician who has experience with taking mammograms of breasts with implants.
Beyond the Mammogram
Mammograms are only part of maintaining good breast health. Patients will want to follow up with their board certified plastic surgeon and conduct frequent self-breast exams as well as continue clinical exams by their primary care provider.
For women with silicone-filled breast implants, MRIs can, in addition to cancer screening, help detect silent leaks in silicone breast implants. MRIs of the breasts are recommended every few years for women who have silicone-filled breast implants. It’s important to note, however, that at this time MRI is not considered better than mammography for detecting breast cancer, and due to its extreme sensitivity, MRI can create many false positives, where something looks suspicious but turns out to be normal tissue. It’s important to talk to your doctor about the best screening option for you.
The Bottom Line
All women, whether they have breast implants or not, should be diligent about getting mammograms and about conducting breast self-exams regularly to better understand the normal contours and texture of their breasts. If you experience any changes or detect any lumps, please make sure to contact your physician immediately.
For additional information or to schedule your annual screening please visit www.charlotteradiology.com or call 704.367.2232.
Charlotte Radiology
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