Can breast implants hide tumors if placed under the muscle?

Question

I had breast augmentation under the muscle 4 years ago and was told that since the implant was placed under the muscle there was no risk of not detecting a tumor or mass, lately I've been reading otherwise, I'm 26 years old and don't have mammograms yet, so can anyone please tell me what the truth is??

Mariam Awada, MD, FACS · Answer

Dear BA patient.  Any implant can make mammogram more difficult but less likely with submuscular.  If the radiologist has difficulty viewing your tissue then they will get alternate view, and ultrasound, or an MRI to better evaluate and be confident that things appear normal.  Trust me they will get the views need to best evaluate your breast when the time comes.  Just be sure you do your part while your young- monthly self breast exams yourself until mammogram time!

Don W. Griffin, MD · Answer

While breast implants do obscure a small amount of breast tissue during mammograms, there is no statistical difference in breast cancer detection rates, the stage of breast cancer when detected, the treatment or survival outcomes between women with implants and women without implants. Subpectoral placement does obscure a little less breast tissue than subglandular placement.

Ronald Schuster, MD · Answer

ALL implants can interfere with the ability to see all of the breast tissue with mammograms. Placing the implant beneath the muscle can improve the chances but is no guarantee. Also keep in mind that not all breast cancers are detected by mammograms. Ultrasounds and MRIs can always be done if there is any issue or concern. I also teach my patients the importance of good self examination which can be done easily regardless of where the implant is placed.

William Andrade, MD · Answer

Hello, implants are inserted deep to your breast tissue so it would be very unlikely for a tumour to develop even deeper than the implants.  However, they could affect mammogram screening.  This is something to discuss with your PS because they will know your full breast history including risk factors for breast cancer.

Alexander G. Nein, MD, MS, FACS · Answer

It's
unlikely that breast implants placed below the muscle could hide a tumor. Unfortunately,
mammography is not a perfect science, even without breast implants thrown into
the mix. While technology does continue to improve, it is still best for women
with denser breast tissue or breast implants to keep up with regular mammograms
(they should be performed yearly on women starting at age 40) and self-performed
breast exams and doctor-performed breast exams (for women under 40).

Lynn D. Derby, MD (retired) · Answer

Breast cancer screening with implants requires extra views on your mammograms (Ecklund views) where the implant is pushed back, out of the picture, in order to see the areas which are in the implant's shadow in regular views.  Otherwise, breast cancer screening is the same as for women without implants.  What are the chances that a breast cancer could be missed because it was hidden by the implant?  As far as we can tell, very small.  Can anyone please tell you what the truth is?  The truth is that nobody can give you a 100% certain answer from medical research.  You can gather data and crunch the numbers, but you are always limited by the infinite variations between individual people and the number of available study volunteers.Here is my summary of the issue:  Most of the clinical studies done to date have found no significant differences in breast cancer rates and survival rates between women with and without implants.  The only study to suggest an increased risk to survival was a 2013 meta-analysis (a study where data from multiple clinical studies is combined.)  The difference was small and the authors of the study concluded, "These findings should be interpreted with caution, as some studies included in the meta-analysis on survival did not adjust for potential confounders. Further investigations are warranted regarding diagnosis and prognosis of breast cancer among women with breast implants." To put it into perspective, your genetic and lifestyle risk factors, and whether you do your monthly self-exams and get your mammograms on schedule, are more important than whether you have breast implants, either over or under the muscle.It would be helpful to know what you have been reading in order to discuss it more specifically.  The media tends to sensationalize medical issues, and breast implants are one of their favorite targets.*BMJ 2013;346:f2399

Can breast implants hide tumors if placed under the muscle?

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