Mammogram & Breast Augmentation. Can Implants Obscure the View During Mammograms?

My question has to do with breast cancer detection and augmentation. When I had my last mammogram the radiology tech said that the implants can obscure the view of tumors/cancer that a mammogram would normally pick up. Have studies been done on this? Thanks!

Doctor Answers (12)

Yes, MRI and ultrasound can add additional information

+3

Hello,

Yes, the very nature of mammograms makes having a breast implant result in less visibility of the breast tissue.  Other techniques such as MRI and ultrasound do not have this issues and can be used instead of the mammogram or in addition to the mammogram for additional information.  I am not sure when the transition will occur but is makes sense that at some point mammograms may take a back seat to MRI and/or US since these techniques do not expose the breasts to radiation. 

All the best,

Dr Remus Repta


Scottsdale Plastic Surgeon
5.0 out of 5 stars 81 reviews

Mammography and implants

+2

Yes, there have been studies that have shown that implants can mask some tissue on mammography.  MRI is probably the most sensitive test if there is any thing suspicious. 

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

Breast Augmentation and Mammography?

+2

Thank you for the question.

 Yes, breast implants can decrease the amount of breast tissue visualized on mammography.  Nevertheless, mammography remains a useful screening to detect breast cancer.  You will find that the mammography centers will use “displacement techniques” to help minimize the interference of breast implants with breast tissue visualization.

Sub muscular ( dual plane) breast implant positioning decreases this interference compared to the sub glandular breast implant positioning. Based on studies that I am familiar with the loss of breast tissue visualization caused by sub muscular breast implants is approximately 6%.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 680 reviews

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Mammogram & breast augmentation. Can implants obscure the view during mammograms?

+1
Hello!  Thank you for your question!  This a great question, which is often asked by patients.  There is no link to breast implants, either saline or silicone, and cancer.  All supporting literature has demonstrated this fact and no association with cancer, autoimmune disorders, or autoinflammatory disorders.  

It is known that women are more in tune with their breasts and more diligent with examination and feeling/knowing the contour of her breasts, thus able to identify any abnormality sooner.  Imaging studies of the breasts are similar to imaging without breast implants and cancers are not hidden either by the presence of breast implants.  It is true that with breast implants do obscure a portion of the breast during imaging studies, but with the Eklund displacement views, which should be done when having mammograms with breast implants, there is minimal change.  You should remain proactive with your monthly self examination, annual clinical examination, and mammograms beginning at age 40 (unless family history, as directed by the Radiological Society).  If there is anything concerning on mammogram, other imaging modalities would be utilized, including ultrasound and/or MRI.  Best wishes!  Hope that this helps!

Lewis Albert Andres, MD
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MAMMOGRAMS AND BREAST IMPLANTS

+1
It is important to let the mammography facility know about breast implants when scheduling a mammogram. The technician and radiologist must be experienced in performing mammography on women who have breast implants. Implants can hide some breast tissue, making it more difficult for the radiologist to detect an abnormality on the mammogram. If the technician performing the procedure is aware that a woman has breast implants, steps can be taken to make sure that as much breast tissue as possible can be seen on the mammogram. A special technique called implant displacment views may be used.

Be well and good luck!

@norrisplastic

Morgan E. Norris, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 16 reviews

Mammogram and breast implants

+1

The simple answer is yes implants do obscure breast tissue more than native breast mammography.

The important aspect of screening is a multimodal approach, ie

  • Clinical exam. There have been some studies that show that implants infact increase clinical detection of lumps because they push the tumour more superficially.
  • Imaging, be that mammogram, USS or MRI
  • biopsy of suspicious lesions

I hope this helps.

 

Pouria Moradi, MBBS, FRACS
Sydney Plastic Surgeon
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How do Breast Implants affect Mammography?

+1

Mammography can still be performed with breast implants in place. Mammography technicians are trained to use specialized techniques for women with breast implants that help to image the breast tissue around the curved surface of the implants. Be sure to let the mammography provider know that you have breast implants when you schedule your mammogram.

It is not possible to obtain a mammogram by imaging through the implants, only around them. Breast implants therefore potentially do reduce a radiologist's ability to visualize breast tissue completely. This is more of a concern with implants placed immediately behind the breast ('sub-mammary', aka 'sub-glandular' position), so for that reason the sub-pectoral position is strongly preferred.

There is no conclusive evidence which shows that women with breast implants are diagnosed with breast cancer at a later stage than women without implants - which one would expect if breast implants actually delayed the detection of breast cancer. Likewise, women with breast implants do not appear to have a higher mortality rate from breast cancer compared to women without breast implants. Breast implants do not obscure or interfere with patient self-examination or physician breast examination, which are at least as important as (if not more important than) mammography for breast cancer screening.

Mammography is currently the recommended mass screening test for breast cancer, but it has significant limitations due to a high number of false positives (which leads to biopsies when no cancer is actually present) and false negatives (which means a cancer is missed when it is present). The most sensitive and specific radiologic test for breast cancer is a contrast-enhanced MRI scan, which refers to an MRI that is enhanced by the administration of an intravenous 'contrast' agent. The contrast agent helps to 'light up' a breast cancer on the MRI scan when one is present. Breast implants do not interfere with breast MRI scanning in any way.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 37 reviews

Mammograms And Breast Implants

+1

Hello,

Thank you for an important question.

Breast implants do obscure certain breast areas during mammography as they cast "shadow" over the tissue.

That being said, mammographers with good experience know how to position their patient and manipulate the breasts implants to cover the entire breast tissue.

Also, ultra-sound imaging can be used as an addition or a possible alternative to mammography.

In cases of doubt, an MRI will be sufficient to unveil abnormalities with great precision/resolution.

I hope this helps.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
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Mammogram & Breast Augmentation. Can Implants Obscure the View During Mammograms?

+1

Thank you for this excellent question. This has been looked at very thoroughly in the medical literature. From the studies I have seen about 1/3 of breast tissue can be hidden by implants on mammogram, resulting in an increased incidence of false-negative (telling a patient the mammogram is normal when it really is abnormal) mammograms. Breast cancer studies of women with implants reported no significant differences in cancer stage at the time of diagnosis, and prognoses, or prediction of long term outcome, are similar in both groups. Interestingly, patients with breast implants are more often diagnosed with palpable tumors on physical exam which indicates that equal sized tumors in augmented and non-augmented patients might be more readily found in augmented patients, which might compensate for the impaired mammogram images. The idea is that in augmented patients there is a hard background created  by the implant which may make it easier to feel a mass in the breast compared to a women without an implant. However, this is no reason to run out and have a breast augmentation.  Mammogram still remains a very powerful screening tool and is very necessary in my opinion. There is a special technique called the "Eklund view mammogram", whereby the radiologist can push the implant away against the chest wall and thus bring more tissue into view, but still misses 1/3 of the breast tissue.  If mammogram or physical exam raises suspicion then follow up tests such as Ultrasound can be done but the gold standard would be an MRI. If you are diagnosed with breast cancer and have breast implants, the implants will not have any affect on the surgical technique to remove the tumor and if you require radiation treatments the implant will not interfere with that treatment. Great question!! I hope this makes sense.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
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Breast Implants and Breast Cancer Screening

+1

Great question.  Yes, you are correct.  Breast implants can create a "shadow" effect on a standard mammogram hiding 3-5 percent of breast tissue.  However, additional views or an additional non-invasive ultrasound can visualize the tissue in the "shadow."  If there is any concern beyond that, then an MRI can do the trick.  Studies have shown clearly that breast implants do not delay the diagnosis of breast cancer.  Implants also do not increase the risk of breast cancer.  Hope this addresses your concerns.

Dr. Basu

Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 113 reviews

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.