Mammography and Capsular Contracture? (photo)

Question

I am 35 years old, 12 year old saline breast implants sub glandular placement. I have what seems to be a cystic mass under my areola of my Left breast. I also have III or IV capsular contracture in that breast. My FNP ordered a diagnostic mammogram on the left breast, but I am scared that with the Capsular Contracture and age of my implants that it may cause a rupture and not get a good view anyway. I think ultrasound might be better - but the FNP won't consider it. Drs please weigh in.

Kenneth Hughes, MD · Answer

I would agree that for diagnostic purposes, the sequence in the breast mass for women 35 years and older should be mammography, ultrasound, then MRI, if necessary.

Kurtis Martin, MD · Answer

It is possible for a mammogram to lead to rupture of an implant (especially with a capsular contracture). If this is a concern, get an ultrasound of MRI.

Thomas Fiala, MD, FACS, FRCSC · Answer

Actually, ultrasound is a better modality to evaluate where a mass is cystic or solid.  But a mammogram is better for looking for microcalcifications, which are a hallmark of breast cancer.

	I probably would have ordered both tests.

	Tell your radiology tech about your concerns.  The risk of implant damage from mammography is low - but unfortunately, it's not zero-risk.

Steven Wallach, MD · Answer

Mammogram first, Ultrasound second, MRI if equivocal.  And biopsy if a mass is identified. Follow closely with your PMD.  Good luck.

Darryl J. Blinski, MD · Answer

I ABSOLUTELY recommend a mammogram FIRST than a possible ultrasound. Why play around with the issue of a breast cancer possibility!!!

Mammography and Capsular Contracture? (photo)

Answers (8)