I have silicone gel implants and I'm worried about future mammograms causing silent ruptures. My implants will be 16 years-old by the time I get my 1st mammogram. What is the likelihood of a mammogram rupturing an implant? I know that MRI's are the best option for silicone gel breast implants, but I doubt my insurance will cover this. Plus, I don't want my insurance to know I have breast implants because I'm scared they'll drop me. I'm considering switching to saline implants prior to needing mammograms because at least I can tell if it ruptured or not. Advice/suggestions appreciated.
Can a Mammogram Rupture a Silicone Gel Implant?
Doctor Answers 14
Mammograms and ruptured breast implants
The mammogram probably cannot rupture an intact implant but it can release the scar envelope around an implant and if the implant is already ruptured, the gel can then escape into the tissues.
I once took care of a patient on whom exactly this happened. She had old gel implants placed years before. They were ruptured but contained within the capsule. They were below the muscle. The mammogram tore the capsule and the pressure of the exam injected the gel up through the pec muscle into the breast tissue. This was all captured live on the xrays.
An MRI can't do this so it might be the first thing to do.
Don't get rid of your silicone breast implants just yet! Options for rupture detection
I share your concerns with my patients. Howver, recently there has been some research that has shown that high resolution ultrasound may be a very effective tool for diagnosing silicone breast implant rupture.
Another option is that many MRI facilities are willing to charge significantly less for cash prepay. Whereas an MRI may run up to $3000 at a hospital facility, many free standing centers are willing to perform the servce for around $400. Call around and ask!
I hope that this helps
Mammograms are OK
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Mammogram with Silicone Implants
Can a mammogram rupture a silicone gel implant?
Highly unlikely for an implant be ruptured by a mammogram
It is highly unlikely that a mammogram would ever rupture an intact implant. With the new form of breast implants produced after 2009 there is little chance of the implant gel material migrating since the gel is more cohesive than it was prior to this time. Therefore it may be difficult to tell if it is ruptured since the implant tends to keep its original shape. The problem is non an emergency. You would need some type of diagnostic study to determine if it was actually ruptured such as a mammogram, MRI or ultrasound.
Mammography after breast Implants
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.
Mammograms And Implant Rupture?
Thank you for the question.
Although theoretically possible it is very unlikely/unusual that a mammogram would rupture any type of implant. Every experienced plastic surgeon probably has anecdotal evidence to the contrary but it is hard to prove if the suppose it mammogram related rupture was really causative. In other words, the implant may have ruptured prior to the mammogram study.
In your case, given that your implants will be 16 years old, I would suggest an MRI. As you know this is the most useful test to evaluate the integrity of the silicone gel shell.
I hope this helps.