About Breast Cancer Screening With Implants

Breast cancer screenings may require some special considerations, especially when you have implants. “It is not as simple as putting in the implants, and you’re done,” Jay Baker, MD, chief of the division of breast imaging at Duke University Medical Center, said to Health.

“Downstream issues, like how implants affect regular screening mammograms, often aren’t discussed in as much detail as they should be when a woman has implant surgery,”

Experts recommend breast cancer screenings, known as mammograms, annually or biennially beginning around age 40, regardless of whether you have implants. The USPSTF recommends that women and people assigned female at birth receive biennial mammograms beginning at age 40. Discuss with a healthcare provider whether you need a mammogram if you’ve had an implant after a mastectomy.

Do you have implants, or are you considering getting them? These facts and tips may help you navigate your routine breast cancer screenings and any associated diagnostic testing your healthcare provider recommends.

1. Know How They Feel

Get familiar with your new normal if you’ve had breast augmentation or reconstruction. “We do recommend that if a patient has an implant in place, she becomes familiar with the implant,” says Sameer Patel, MD, associate professor in the department of surgical oncology at Fox Chase Cancer Center, to Health.

Discuss with a surgeon how you can feel what breast tissue is and what an implant is. Implant recipients may believe that they can feel a lump in their breast, but what they are actually sensing is the implant. Saline implants may bulge like a partially filled water balloon.

Research has shown that if the breast cancer happens it is more likely to occur at smaller implant sizes especially to palpable lumps of self-exams or by clinical breast exams. 4 Dr. Baker advises any person who feels a lump to get checked. Do not assume that all lumps are from your breast implant or to overlook them.

2. implants decreases detection of breast cancers.

Mammograms don’t penetrate well in saline or silicone. It might be a bit harder to identify on a mammogram depending on where the cancer is. “It is doable; we do it all the time, [but] it does make things a little trickier,” said Dr. Baker.

According to research, the detection rate of cancer through screening mammography is 77.8% for women with implants. The rate is lower than that of women without implants, which is 90.7%.

“The outcome in patients that do develop breast cancer, even with implants, is the same as those without implants,” said Dr. Patel, despite the limitations of mammography screening in people with implants.

3. Mammography Team be notified

When you schedule a mammogram, let the scheduler know you have implants. Ask if the staff has experience screening patients with implants. Give the mammogram technologist a heads-up before your imaging procedure begins.

The technologist needs to know two things. One is how to position the patient. The other is how much compression to use, said Dr. Baker. An experienced technologist will know how to compress the breasts carefully without rupturing it.

4. Additional Pictures May Be Required

A routine mammogram makes four images in two views of each breast. In individuals with implantation, additional views-two of each breast are typically needed. These additional images are obtained in case tumors may hide behind the implanted breasts.

“They’re called implant displacement views,” Dr. Patel said. The breast is pulled out, so the implant is pushed towards the chest wall “so more of the breast tissue is visualized with the mammogram.”

Implant displacement views involve relatively little compression. A healthcare provider uses “just enough to keep the breast still,” said Dr. Baker.

5. Rupture of the implant rarely occurs with mammography

Do you feel that with compression of your implant it could rupture? Rupture has been reported, but very infrequently by studies. According to the Food and Drug Administration (FDA), there have only been 17 cases of breast implant rupture under compression.

Around 200,000 women each year get breast implants. something’s the implant might already have broken down, “and compression just finishes the job,” explained Dr. Baker.

 

 

6. Further screening procedures could be necessary

The preferred method for screening for breast cancer is still mammography. If you have implants, your healthcare professional may suggest more imaging.

Ultrasonography

“Typically, we only perform ultrasound screening on women who are at a higher risk [of breast cancer] or women with dense breast tissue,” Dr. Baker said. “A screening ultrasound is a consideration” in the event that implants make it difficult for the radiologist to see breast tissue.

Since mammography and ultrasound provide different information, they cannot be used interchangeably. Ultrasound does not detect microscopic calcium deposits which may be an indication of cancer in the breast, but mammography does. A small-sized lump hidden under the implant that mammography cannot identify may be detected through ultrasound.

The American Cancer Society. ultrasonography of the breasts.

Biopsy of Needles

If a suspicious area of breast tissue is found, a needle biopsy can be performed to extract a sample of cells for examination in the lab. “I always tell patients if there is a needle and an implant in the same breast, there’s at least some chance of causing an implant rupture,” said Dr. Baker. “It is rare, but it is absolutely possible.

7. Lymphoma Risk is There

There is no general correlation between breast implants and a higher risk of breast cancer. Age, being overweight, having a family history of the disease, or inheriting certain genetic abnormalities all increase one’s risk for breast cancer.

The American Cancer Society. important facts about breast cancer.

In any case, the FDA related breast implants to a significantly elevated risk of one form of a rare lymphoma. Known today as breast implant-associated anaplastic large cell lymphoma, this type of lymphoma is characterized.

• BIA-ALCL manifestations:
• Asymmetry, lumps, pain, redness, swelling within the breasts.

The implants and surrounding tissue are usually removed as part of the treatment. In some cases, a doctor may recommend radiation combined with chemotherapy.

As of 2023, the FDA reported 1,264 cases of this malignancy, with 62 deaths. An advisory group conducted a two-day hearing on the benefits and risks of the implants in 2019. Two manufacturers of the implants also received warning letters from the FDA for failing to conduct long-term safety studies.

The Food and Drug Administration. Two manufacturers of breast implants receive warning letters from the FDA for failing to comply with postapproval research requirements.

8. Problems May Need to Be Eliminated

If you are found to have breast cancer, the decision to have removal of the implants is usually left to you. As such, it is important for you to discuss your breast cancer type and the likely treatment that you should opt for with your doctor.

Capsular contracture is said to occur more in women who are treated with implants and irradiation for breast cancer according to a 2022 study. Radiation therapy leads to the formation of a thick, hard, and uncomfortable fibrous tissue around the implant.

Nelson JA, Polanco T, Cordier PG, et al. Relationship between radiation scheduling and health-related quality of life and long-term satisfaction in prosthetic breast reconstruction. 150(1):32e–41e in Plats Reconstrue Surg. 2022; doi:10.1097/PRS.0000000000009180

According to Dr. Patel, in worse cases, it can even change the appearance of the breast externally, distorting its form and even becoming visible through the skin.

According to Dr. Baker, implant removal is not necessary for mammography alone. “I would never recommend that a woman remove her perfectly functioning, intact implants to improve her screening,” he said.