I'm considering Breast Implants and wanted to ask what are the recommendations or risks associated to monthly breast self exams and/or screening for breast cancer. Are the precautions any different from the "usual"?
Changes to Breast Screening After Having Breast Augmentation?
Doctor Answers (7)
Breast Cancer Screening
There are no studies that have show women with breast implants are at a higher risk of breast cancer or missing a cancer.
Breast implant augmentation surgery and breast cancer detection
Your exams are essentially the same but addtional views are required with Mammography and are called Eklund compression views. In patients with pre-existing breast cancer, a few studies have shown delays in diagnosis but no change in survival. MRIs may provide improved visualization of the breast tissue.
Breast cancer screening and breast implants
With breast implants, you need special technique and special views when getting a mammogram. So you need to go to a mammographer who sees a lot of breast augmentation patients.
Otherwise screening and self examination are the same.
One very reassuring recent study showed that women with breast implants actually have a lower risk of breast cancer than the general population.
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You will need a diagnostic mammogram.
There is only one change you need to make. Once you have breast implants, you are no longer a candidate for a screening mammogram. What you will need is called a diagnostic mammogram. The difference is in the number of views taken. A screening mammogram uses only 2 views. A diagnostic mammogram uses as many views as needed to visualize all the breast tissue. Studies have shown that with this change there is no difference in detection of breast pathology between women with or without implants. If you do have a cancer found, it is at no later stage and the cure rates are the same. Studies have also shown that the implant generally makes it easier to detect a problem by breast self exam. Essentially, all you have to do after a breast augmentation is make sure that you have the proper type of mammogram and all other risks and precautions are equal. From a breast cancer standpoint, there is no reason not to have the augmentation.
Precautions after breast augmentation
Specifically answering your question, no there are no risks or additional precautions that you need to take after getting breast implants for breast.
What is the current recommentation?
In the middle of your cycle after the age of 25 you should be doing your self breast exams monthly. You should get your first mammogram at the age of 40 (unless you have a family history). When patients have implants there are techniques that your breast center should have to compensate for the presence of implants by getting additional views. The mammogram for you will thus be using the diagnostic mammogram techniques rather than the usual screening techniques. If they know about adding these views then they are probably an adequeate center to screen you properly. If they are unfamiliar or simply don't mention the implant in the read... run for the hills. This has happened to me with some patients that go to little screening centers that want to do the business but aren't really familiar with what is necessary to properly view the breasts.
The group that determines the recommendations of when to get your first mammogram (The American College of Chest Physicians) has never added breast augmentation as a reason to getting your first mammogram at a different age. Some of us Plastic Surgeons however start our patients off after doing breast surgery after the age of 35 by getting a mammogram which is about 5 years ahead of schedule but that's not agreed upon, it's just something some of us have decided to do. You should consult with your ABPS Board Certified Plastic Surgeon for his suggestions for this.
Lastly, if you get silicone implants your implants will have suggestions on how to monitor them for rupture (this is unrelated to your question on breast cancer screening).
Mammography after Augmentation Mammoplasty
When you set up your mammography be sure to tell the scheduler/technician that you have had breast implants and you can also question their expertise or experience in dealing with patients who have had implants. Most mammographers today are quite skilled and limitations can be overcome with varying the views and sometimes with MRI (which may not be covered under your insurance). It would be helpful if you also note to them that your implants have been placed in the submuscular or the subglandular position. Remember also that IF a suspicious lesion is noted that there is no reason that a biopsy and subsequent treatment can't be performed without a compromise of the ability to cure or treat the cancer. One in 6 women, unfortunately, in the USA will develop a breast cancer during their lifetime, so be faithful about follow up exams and mammograms as well as breast self exam.
Breast Cancer Screening and Detection is Different After Augmentation
Because an implant is in place, sometimes extra or special views of the breast must be taken during mammography. If you develop capsular contracture, the ability of the radiology technician to manipulate the breast tissue during mammography may be limited, which could interfere with mammography.
As for breast self exam, research indicates that breast implants may actually help with a woman detecting a mass.
While breast implants do affect mammography, studies have NOT shown that having breast implants results in a cancer being detected at a later stage, or having a worse outcome.
There will be newer techniques to image the breast over the next decade, including high-definition mammography, MRI, ultrasound, and radionuclide studies. Used in combination, it is hoped that these more advanced tests will make the detection and early treatment of cancer even more effective.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.