Contributing Plastic Surgeon: Dr. W. Grant Stevens, M.D., F.A.C.S.
Medical Director of Marina Plastic Surgery Associates, Los Angeles, CA
Breast enhancement implants aren’t designed to last forever, but they are tougher than you think. Some women believe that getting a mammogram may cause an implant to rupture. It’s true that squeezing your breast between two metal plates to get a clear picture can involve quite a bit of pressure (up to the point of being pretty painful). But, according to the American Cancer Society, breast implant rupture during a mammogram is very rare.
You do need to tell your technician what type of implant you have (saline or silicone) and where the implant is placed (over or under the pectoral muscle). That way, they can use the correct techniques when taking your films. The tech performing your mammogram will need to take two extra images of each breast. These are called implant displacement (ID) films and they are designed to show the part of the breast that is typically hidden by the implant. If you have an average risk of breast cancer, you won’t need to get mammograms more frequently than women without breast implants.
What about MRIs?
If you have silicone gel implants, the FDA recommends that you have them checked by MRI every two years to make sure they aren’t leaking. Women who follow this recommendation may wish to substitute their MRI screening for a mammogram. They should discuss this plan with their doctor and the technician to make sure their MRI is thoroughly screened for signs of cancer.
Some hospitals actually have equipment such as the Sentinelle Vanguard breast MRI coil that is designed specifically for taking images of the breast. This technology is currently expensive compared to traditional mammography and is generally reserved for screening high-risk patients. But it may someday replace x-ray mammograms as the standard of care. That would be a boon for women with silicone breast enhancement implants since they could check for breast implant rupture along with their regularly scheduled mammogram.
What if An Implant Does Rupture from Mammography?
Your implants are covered by a warranty. If you experience breast implant rupture during a cancer screening, the manufacturer will provide a new implant. Replacement surgery will typically be much less uncomfortable and have a shorter recovery than your initial implant surgery since the pocket to hold the implant has already been created. According to the National Cancer Institute, one out of eight women alive today will develop breast cancer at some point. The risks of skipping regular screening and missing a tumor are much more significant than the risk of rupturing an implant.
Breast Enhancement Implants and Breast Cancer Risk
There is no evidence that implants themselves increase the risk of developing breast cancer or any other systemic disease. But what about the idea that breast implants can make cancer more difficult to detect?
There is always going to be some breast tissue that can’t be captured on mammogram x-rays. This is true for all women, not just those with breast enhancement implants. The percentage of tissue that can’t be seen on a mammogram is about the same for women with and without implants (assuming ID films are taken properly) – it’s just in different locations within the breast. However, capsular contracture can make mammograms harder to take and more difficult to interpret, something you should discuss with your doctor if you have this side effect from surgery.
Because early diagnosis is the key factor in successful treatment, women who have breast enhancement implants should follow their doctor’s advice regarding frequency of mammograms. In a study entitled “Effect of Breast Augmentation on the Accuracy of Mammography and Cancer Characteristics” published in the JAMA in 2004, researchers found that implants can decrease the sensitivity of breast cancer screening slightly.
However, the difference was not significant enough to affect treatment outcomes. There is no increase in breast cancer mortality