Summation Shadow Under Right Breast Implant

a summation shadow showed up where my scar is under the right side of my breat implant, it appears to be scar tissue. Is this normal? I have no pain. I was having an x-ray for knee surgery.

Doctor Answers (7)

Summation shadows are usually nothing to worry about.

+2

If an abnormality is detected on an xray that is worrisome, your radiologist might ask for additional views or recommend other treatment/evaluation.  Provided they've not asked you to do anything further, you can assume that they do not feel it necessary to worry. 

To be safe, it is always my advice to question the radiologist who performed the test and/or ask the same of the physician who ordered the test to see what they recommend.


Ogden Plastic Surgeon
5.0 out of 5 stars 20 reviews

Shadows on xray after having breast implants

+2

The combination of breast tissue, scarring from prior surgery, and a breast implant can certainly produce a summation shadow on a plain film (such as a chest xray). 

You should follow up with your primary physician or GYN, whichever manages your mammgrams at this point.  It may be time for a mammogram or ultrasound to confirm that what was seen on the chest xray is just a summation shadow and not something more concerning.

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 18 reviews

Mammography and Breast Implants

+2

Towson,

Interesting question.  Summation shadows are usually normal (this is a radiographic image of materials overlying one another).  Nevertheless, This raises important questions:  Your age and family history help to decipher your risk of breast cancer.  This is a fear of most women.  If you are over 40 or have immediate family relatives with breast cancer, seek a mammogram.  If you are younger and otherwise healthy with no family history of breast cancer, perform regular self exams and follow up with yoru plastic surgeon.

Jason R. Hess, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 8 reviews

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Summation Shadow Needs Follow-Up

+2


Thanks for your question about a summation shadow on a radiograph (chest X-Ray).
A summation shadow is an overlap of normal structures such as breast glands, or even an implant.

If the radiologist is confident that a density is a summation shadow is a result of an overlap of normal tissues, then he/she would call it normal and recommend a routine (annual) follow-up mammogram.
If the doctor is not sure, small spot compression views can be performed to help differentiate summation shadows from abnormalities.
Spot views apply the compression to a smaller area of tissue and make it easier to determine if there is an abnormality requiring other tests like a follow-up mammogram.
Most likely all is fine, but, it is important to discuss with your doctor and get a follow-up x-ray or mammogram to be sure..

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 13 reviews

Shadow on imaging of breast briefly notd by patient

+1

This does not sound to be a major concern and most likeley will require a follow up xray to insure a stable appearance.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Summation shadow noted on screening X-ray not necessarily a concern.

+1

As noted here by others, this is probably of no concern. However, the important word in the previous sentence in highlighted!  There must have been a reason the rqadiologist mentioned this--was it out of thoroughness, possible real concern, or was it to just "cover himself or herself?" While I can indeed understand the latter, particularly in this age of lawsuit-happy people, perhaps we can give the radiologist the benefit of the doubt, and take it for what it is: it was seen, it may mean something, and therefore was officially reported. If you are a cynic, you might even think that the radiologist was unscrupulous and simply wanted to stimulate the "need" for additional follow-up X-rays! Let's hope not.

So if we return to the idea that this could (but probably doesn't) mean anything serious, there are only two possible responses: 1) decide this means nothing and ignore it. Probably OK, but there's that highlighted word again. What if you are wrong and it does mean something that could have been detected early? Was the radiologist willing to bet your life on that? Are you?

2) decide that this needs at least further discussion and maybe more follow-up. I'd start by asking your doctor to speak with the radiologist and determine what he or she meant by use of the term summation shadow. In itself, this is a radiologic normal occurrence. So why mention it? If it warrants further follow-up in your doctor's and radiologist's agreed opinion, likely one additional X-ray will conclusively answer the question.

Good luck, and in the meantime, don't worry!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 126 reviews

Summation shadow is a normal finding on x-ray.

+1

A summation shadow is a normal finding on chest x-ray when breast implants are present.  It simply means the radiologist is seeing two "shadows" intersect and combine to form a more dense area on the x-ray.  It has nothing to do with the scar of the skin most likely.

Richard H. Fryer, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 85 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.