Mammography and Capsular Contracture? (photo)

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.

Doctor Answers 9

Mammogram and rupture of implant

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.

Cincinnati Plastic Surgeon
4.8 out of 5 stars 73 reviews

Mammography, Ultrasound, and MRI for Breast Mass in Women 35 and Older

   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.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Breast evaluation

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

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Mammography and Capsular Contracture?

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

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews


the ultasound is the better test to dettermine if a mass is solild or cystic. They all eventually will need fine needle aspiration or biopsy if suspicious.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Cystic mass?

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.

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

Change the Implant(s)

Get the mammogram because its the best diagnostic method to determine what is going long as the technician performing the study is careful there shouldn't be a risk to your implant...  In any case, as soon as this issue is addressed, I would recommend redoing your breast implants and probably replacing them with silicone gel implants.  At the least, you should redo the left breast to treat the capsular contracture and improve its appearance to better match the right breast!

Eric Sadeh, MD
Manhattan Plastic Surgeon
4.2 out of 5 stars 57 reviews

Mammogram or sonogram

If you have a grade III-IV capsular contracture, you should be giving consideration to replacing the implant. In terms of the mass in the left breast, mammography is the diagnostic procedure of choice for evaluation of that lesion, which should take precedence. You should, of course, tell the technician that you have implants so she can take as much care as possible.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Mammograpy and Ultrasound Are Important in Breast Evaluation

Thank you for your question.  Mammography is a standard part of screening for breast cancer.  Wile cysts also need to be evaluated with an ultrasound, it cannot be subsituted for a mammogram for diagnostic screening.  Both tests give you different information.  While your capsular contractures and the implant are a concern, your breast health is more important.  If you have further concerns, you should consult with an oncologic breast surgeon for addiional advice.  Good luck!

Robert F. Centeno, MD, FACS
Columbus Plastic Surgeon
4.9 out of 5 stars 77 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.