Medical Moment: Do breast implants affect mammograms?

Perhaps you’ve read or heard that breast implants complicate mammogram readings, prompting you to wonder whether yours make the screening guidelines inapplicable for you. Maybe you’re even considering skipping your annual mammogram, questioning its worth.

But Dr. Ana Benveniste, breast radiologist at Houston Methodist Baytown Hospital, stresses that all women benefit from getting an annual mammogram — including those with breast implants.

“If we can find and treat breast cancer early, it’s almost always curable,” says Dr. Benveniste. “And the only way we can do that is if you come in for your annual screening mammogram. Having breast implants doesn’t change that.”

Still, you might have some specific questions about how breast implants affect your breast cancer risk and mammogram readings.

Do breast implants cause breast cancer?

The two most common types of breast implants used today, saline and silicone, aren’t associated with an increased risk of breast cancer. This means that a woman doesn’t need to be screened earlier or more frequently just because she has breast implants. There are very unusual cancers related to breast implants such as “Breast Implant-Associated Lymphoma” (BIA-ALCL) – it is a type of non-Hodgkin’s lymphoma (cancer of the immune system and it is not a breast cancer) and “Breast implant-associated squamous cell carcinoma” (BIA-SCC) – it is a very rare but potentially aggressive, epithelial-based tumor that appears to emanate from the breast implant capsule (it is not a breast cancer).

Primary risk factors for breast cancer include:

  • Increasing age
  • Breast density
  • Mutations (changes) in certain genes, such as BRCA1 and BRCA2
  • Family history of breast cancer

How often should you get a mammogram?

The breast cancer screening guidelines for women with an average lifetime risk of developing breast cancer with breast implants are the same as for women without them.

“It’s still an annual screening mammogram — once a year — starting at age 40,” says Dr. Benveniste. “This is the gold standard recommendation that all women benefit from, which the data has proven over and over.”

If your risk of developing breast cancer is high, however, your doctor may recommend beginning annual mammograms earlier — as early as age 30. But having implants doesn’t put you at higher risk.

Reasons a woman may be at higher risk for breast cancer include:

  • Genetic testing has revealed that you carry a gene mutation that increases your risk of breast cancer
  • Having a parent, sibling or child with a known breast cancer gene mutation
  • Undergoing radiation therapy to the chest under the age of 25
  • Having Li-Fraumeni syndrome, Cowden syndrome or Bannayan-Riley-Ruvalcaba syndrome, all rare genetic disorders that increase the risk of certain cancers

Do breast implants affect mammograms?

In short, yes.

Breast implants make it harder to see the entirety of your breast tissue on a mammogram, potentially obscuring findings.

“On a normal mammogram, we evaluate the tissue all the way from the nipple through the pectoralis muscle to the chest wall,” explains Dr. Benveniste. “However, when you have an implant, the posterior tissue of the breast is blocked from the mammographic field of view. Since we don’t have a clear view all the way back to the chest wall, findings could be missed.”

Both common types of implants, saline and silicone, affect mammogram readings in a similar fashion.

Not to worry, though. Mammography technologists know how to work around this, which is why it’s important to let your breast-care team know if you have implants before or at your appointment.

How are mammograms done with breast implants?

In addition to taking the traditional full-field views of your breasts — two images per breast — several more pictures are taken of women with implants. These extra images, called implant-displaced views, help the radiologist evaluate tissue that would otherwise be blocked by the implants.

“After the standard images are taken, the mammography technologist manually pushes the implant back while pulling the breast tissue forward — in front of the implant — and compressing it,” says Dr. Benveniste. “Two more images are then taken. This process helps penetrate as much of the breast tissue as possible, providing images in which the implants are no longer obscuring the tissue.”

This is repeated for the other breast — leading to four images per breast, eight images total.

While more images are needed because of breast implants, Dr. Benveniste notes that there isn’t any exam instead of the mammogram recommended for women with implants.

“There’s also no official recommendation for additional types of screening because of them,” adds Dr. Benveniste. “Additional imaging, such as a breast ultrasound, may be recommended if you also have dense breast tissue, but not because you have implants.”

Can a mammogram cause a breast implant to rupture?

A critical part of a mammogram is compression of the breast tissue, which may have you wondering whether your implants are at risk for rupturing during the process.

According to a recent review, breast implant rupture during a mammogram is extremely rare. Remember, the technologist moves the implant prior to taking the implant-displaced views, meaning breast tissue is what’s compressed — not the implant.

In short, worrying about an implant rupturing is no reason to skip your mammogram.

To schedule a mammogram, visit houstonmethodist.org/womens-services or call 346.292.7465.

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