What is a mammogram?
A mammogram is an x-ray picture of the breast. It is used to check for breast cancer in women who have no signs or symptoms of the disease. Regular mammograms are recommended for women over age 40 or 50, depending on risk factors.
Mammograms produce images that can show lumps or abnormalities that may indicate breast cancer. During the test, the breasts are compressed between plates to spread out the tissue and get clearer images. This compression can be uncomfortable.
Do mammograms affect breast implants?
Mammograms can be safely performed on women with breast implants. However, there are some important considerations:
– The implants can obscure some breast tissue, making it harder for the radiologist to interpret the images. Additional x-ray pictures may be needed, possibly including implant displacement views where the implant is pushed back to visualize more tissue.
– The compression during mammography may cause implant rupture or leakage in up to 10% of cases, according to some estimates. Newer generation silicone gel implants are less prone to rupture.
– Implants can interfere with obtaining a clear image of breast tissue near the implant edges. This “imaging artifact” shows up as wavy lines or blurred edges near the implant profile.
– Calcifications commonly form in breast implants as they age. These benign calcifications can be distinguished from the calcium deposits associated with some breast cancers.
– Breast implants can make performing mammograms more difficult and lengthy. Inform your mammography technologist about the presence of implants and schedule more time for your procedure.
So in summary, while mammograms can be safely performed on augmented breasts, the implants may somewhat reduce image quality and involve more time and views. But the test remains crucially important in detecting any breast cancers.
Should I tell the mammogram technologist about implants?
It is extremely important to inform your mammogram technologist if you have breast implants. There are several reasons why they need to know:
– They can allow extra time and take additional images to best visualize breast tissue around implant edges.
– They can use implant displacement techniques if needed to see behind the implants.
– Knowing about implants prevents confusion between implant calcifications and calcium deposits that may indicate cancer.
– They can take appropriate care in positioning and compressing the breasts to minimize implant rupture or leakage.
– They will check for implant integrity during imaging to screen for ruptures or leaks.
– Accurate documentation of implant type, placement, and appearance is needed for comparison to future mammograms.
Hiding the fact that you have implants wastes time, reduces image quality, and can hamper efforts to detect potential cancers. Being open about implants enables the technologist to adjust techniques and obtain the most accurate mammogram results.
Are mammograms mandatory for women with implants?
Women with breast implants should absolutely get regular screening mammograms according to standard recommendations, usually starting at age 40-45. Here are some key facts:
– Implants do NOT protect against breast cancer, which can develop in surrounding breast tissue. Mammograms are still required to detect cancers.
– Breast cancers can be more difficult to detect on mammograms with implants present. More frequent screening may be recommended.
– Implants can rupture and leak over time. Mammograms help monitor the condition of implants.
– Expert guidelines all indicate women with implants should undergo mammogram screening. There are no exemptions.
– Insurance will cover screening mammograms for women with implants just like those without. No extra approval is needed.
– While mammograms can be more challenging with implants, radiologists have experience adjusting techniques to get the needed images.
Do not put off mammograms because you have breast implants. They are a vital tool for finding cancers early, when they are most treatable. Discuss any concerns with your doctor.
What techniques help visualize breast tissue with implants?
Getting a clear view of breast tissue on mammograms can be difficult with implants obscuring the images. Mammography technologists have techniques to improve visualization:
– Implant displacement views – The implant is pushed back so more breast tissue can be imaged in front of it. This requires additional views.
– Eklund views – Images angled specifically to show tissue near implant edges.
– Spot compression – Applying focused pressure to small areas to spread out overlapping tissue.
– Magnification views – Zooming in on specific regions provides more detail.
– Implant-specific views – Tailored for subglandular vs subpectoral implant position.
– 3D tomosynthesis – Creates multiple image layers to see through overlying tissue.
– Ultrasound – Soundwaves can supplement mammogram imaging in some cases.
– MRI – Rarely needed, but magnetic resonance imaging provides 3D imaging without breast compression.
The right techniques depend on the individual case. Having an experienced mammogram technologist, providing a full implant history, and allowing more time can all facilitate optimal cancer screening with implants present.
Should I remove my implants to get better mammogram images?
It is uncommon for a woman to need surgical implant removal solely for breast cancer screening purposes. Here are some considerations on implant removal and mammograms:
– Modern mammogram techniques can usually visualize breast tissue adequately with implants still in place.
– Risks and costs of implant removal surgery may outweigh any small incremental gain in mammogram imaging.
– With newer generation silicone gel implants, removal does not substantially improve imaging per recent studies.
– Implant displacement techniques during mammograms allow direct visualization of breast tissue in front of the implant.
– Remove only if a suspected abnormality cannot be properly evaluated with implant in place.
– Removing an intact implant will not necessarily reduce future mammogram imaging challenges if replaced.
– Reasons for prophylactic implant removal should be discussed in detail with your doctor.
Mammogram screening should not prompt an otherwise unnecessary implant removal surgery. But have an open conversation with your providers if breast imaging clarity remains a concern over time.
Can a mammogram cause breast implant leakage or rupture?
The pressure applied to the breasts during mammography can very rarely cause leakage from an existing small tear or rupture of an implant outer shell. Here is some context on mammogram-related implant integrity issues:
– Most implants remain completely intact through the mammogram procedure.
– Estimates range from 1-10% for mammogram-induced leakage rate from previously intact implants.
– Modern silicone gel implants are more robust and less prone to rupture issues.
– Optimal breast positioning and compression minimizes risks. Inform technologists about implants.
– Older liquid silicone and saline solution implants have higher reported leakage rates from mammograms.
– Most leaks and ruptures from mammograms are small and do no produce noticeable changes.
– Implant displacement techniques use less direct pressure over the implant itself.
– Monitoring implant integrity with periodic imaging is recommended regardless.
While not common, existing implant weaknesses can progress to overt leakage or rupture in a small percentage of mammograms. Discuss any specific concerns with your providers. But the overall benefits of mammogram breast cancer screening still outweigh these limited risks for women with implants.
Should I get a mammogram before breast augmentation?
There are no recommendations or requirements to have a screening mammogram performed before undergoing breast augmentation surgery. However, here are some points to consider:
– It may be a good idea to establish a baseline mammogram before implants if you are near the age to start regular screening.
– Diagnostic mammograms may be warranted if there is concern about any pre-existing breast abnormality.
– Some plastic surgeons order pre-op mammograms on women over 40 electing implants.
– Women with family or personal histories of breast cancer should discuss pre-augmentation mammogram timing with their doctor.
– If you will soon turn 40, you may wish to start screening mammograms even if augmentation is planned.
– Breast implants later in life will not prevent the need for routine mammograms.
While not mandatory, establishing a pre-augmentation mammogram to keep on file provides useful comparisons for monitoring breast health over time. But this decision should be made individually based on age, risk factors, and physician recommendations.
How are results interpreted for mammograms with implants?
Interpreting mammogram results is more complex when breast implants are present. Radiologists must take extra care when reviewing and reporting on imaging from augmented breasts. Here is some information on interpreting mammogram findings with implants:
– Distinguish calcium deposit patterns – Benign calcifications are common around implants but may resemble cancer calcifications.
– Look for subtle signs of rupture – Folds, shifts, or water droplets around implant edge.
– Check implant integrity – Assess for leaks, deformation, rotation, or rupture. May require comparison views of each implant.
– Note fluid collection – Seroma or hematoma buildup around implant could indicate issues.
– Identify obstructed views – Recognize if any breast tissue regions are not fully visualized.
– Correlate to prior images – Subtle changes over time may indicate problems.
– Account for image artifacts – Wavy lines or blurred edges near implant profile.
– Request additional views – If needed for clarification or full assessment of all breast tissue.
– Use implant-specific reporting codes – Denotes augmented breast and any associated factors on image.
Proper training and experience is required for radiologists to pick up on the nuances of interpreting mammogram results in the presence of implants. Always go to a center specializing in breast imaging for optimal analysis.
| Implant Location | Mammogram Techniques |
|---|---|
| Subglandular (in front of breast tissue) | Implant displacement, spot compression |
| Subpectoral (under chest muscles) | Eklund views, 3D tomosynthesis |
| Silicone gel-filled | Magnification views, ultrasound |
| Saline solution-filled | Implant-specific views, MRI |
Can mammograms cause breast implants to rupture?
The compression applied during mammography has been linked to rupture of breast implants in some cases. Here are the key facts:
– Risk of implant rupture from mammogram pressure is relatively low, around 1-3%.
– Older liquid silicone or saline solution implants are more prone to rupture issues.
– Newer cohesive silicone gel implants are more resistant to rupture from compression.
– Too much compression pressure and improper breast positioning raises rupture risk.
– Small existing tears in implant shell can progress to larger ruptures from the force.
– Most mammogram-related ruptures are small and do not significantly change the implant’s appearance.
– Symptoms like breast pain, lumps, and shape changes may occur with large ruptures.
– Implant rupture screening is a routine part of the mammogram procedure.
Discuss any particular concerns about mammogram-induced implant rupture with your doctor. But for most women, the importance of regular breast cancer screening outweighs the overall low risk of implant damage. Proper implanted breast positioning and compression helps minimize risks.
Conclusion
Mammograms remain an essential breast cancer screening tool for all women, including those with breast implants. While implants can present some challenges, the test can be performed safely with a few added precautions:
– Inform the mammogram technologist about any implants and allow extra time.
– Use implant displacement and other special views to see tissue behind implants.
– Position implants properly and use appropriate compression.
– Have images interpreted by a radiologist experienced with augmented mammograms.
– Monitor implant integrity at each exam to check for rupture.
– Consider 3D tomosynthesis instead of standard 2D mammography if available.
Do not avoid mammograms because you have implants. Discuss any concerns with your doctor and radiology team. With the right techniques, breast cancer screening effectiveness is maintained for women with implants. While ruptures are uncommon, the life-saving benefits of mammograms substantially outweigh their small risks.