Mammograms and breast augmentation (breast implants) are two important topics in women’s health that often intersect, particularly when a woman with breast implants needs a mammogram for routine breast cancer screening. Here’s a detailed look at both:
1. Mammograms
A mammogram is an X-ray of the breast used to detect breast cancer in its early stages, even before symptoms develop. It is a crucial tool for screening and diagnosing breast cancer.
- Purpose: Mammograms can help detect tumours that cannot be felt and can find microcalcifications (tiny deposits of calcium) that sometimes indicate the presence of breast cancer.
- Procedure: During a mammogram, each breast is compressed between two plates to spread out the tissue. This ensures a clearer X-ray image. While this compression may cause some discomfort, it is brief.
- Types:
- Screening Mammogram: Routine mammogram for women without symptoms, invitations starting at 50, but MBS funded from 40.
- Diagnostic Mammogram: Performed if there’s a lump, pain, or abnormal findings from a screening mammogram.
2. Breast Augmentation (Implants)
Breast augmentation is a cosmetic surgical procedure that involves placing implants under the breast tissue or chest muscles to increase breast size or restore breast volume lost after weight reduction or pregnancy.
- Types of Implants:
- Saline Implants: Filled with sterile saltwater. If ruptured, the body safely absorbs the saline.
- Silicone Gel Implants: Filled with silicone gel, which feels more like natural breast tissue. However, if a silicone implant leaks, the gel may remain within the shell or escape into the breast implant pocket, requiring corrective surgery.
- Placement:
- Subglandular: Implants placed above the chest muscle but under the breast tissue.
- Submuscular: Implants placed underneath the chest muscle, which can offer more natural contouring.
3. Challenges with Mammograms and Breast Augmentation
Women with breast implants can still have mammograms, but there are some challenges and adjustments to the procedure due to the implants:
- Imaging Issues: Implants can block some of the breast tissue, making it harder to see the entire breast on a standard mammogram. This can potentially hide signs of cancer, especially if the implant is placed in front of the chest muscle (sub glandular placement).
- Special Techniques: To ensure that all breast tissue is visible, radiologists use specialized techniques, such as the Eklund displacement view. This involves pushing the implant back against the chest wall while pulling the breast tissue forward to get clearer images.
- Additional Views: Women with implants often need extra mammogram views, known as implant-displacement views, which help in visualizing more breast tissue around the implants.
4. Risks for Women with Implants
- Rupture Risk: Although rare, compression during a mammogram can increase the risk of implant rupture. The risk is minimized with careful handling by experienced technicians, but it is still a consideration.
- Scarring: Breast augmentation can lead to scar tissue formation around the implant (capsular contracture), which can sometimes make mammograms more uncomfortable or difficult to interpret.
5. Recommendations for Women with Breast Implants
- Inform the Radiologist: It’s important to inform the radiologist or mammography technician about the presence of implants before the procedure, as they will adjust their approach to ensure a thorough examination.
- MRI or Ultrasound: In some cases, if mammograms are inconclusive, especially for women with dense breast tissue or implants, doctors may recommend an MRI or ultrasound as a complementary imaging technique. MRIs, in particular, are more sensitive and can provide detailed images without radiation.
6. Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)
Though rare, BIA-ALCL is a type of lymphoma (cancer of the immune system) that has been associated with certain types of textured breast implants. It typically develops in the scar tissue around the implant. Women with implants, particularly textured ones, are encouraged to be vigilant about changes in their breasts, such as swelling or lumps, and seek medical attention if these occur.
Summary
While breast implants can pose some challenges for mammograms, these can be managed with specialized techniques and additional imaging methods. Women with implants should continue to follow their recommended breast cancer screening guidelines and inform their healthcare providers about their implants to ensure appropriate care.