A common concern among people with breast implants is that the compression used during a mammogram could cause the implant to rupture or “pop.” Mammography is the standard medical imaging procedure for breast cancer screening, involving temporary compression of the breast tissue. Modern breast implants are designed to be highly durable, and the procedure is adapted specifically for people with implants to minimize risk. The chance of a mammogram causing a new implant rupture is extremely low.
The Direct Answer: Implant Resilience Versus Compression Force
The compression applied during a mammogram is necessary to spread the breast tissue, reduce the amount of radiation needed, and hold the breast still to capture a clear image. Modern breast implants, whether saline or silicone-filled, are manufactured with robust shells that are tested to withstand significant force. The goal of the compression plates is to immobilize and thin the breast tissue, not to crush the implant.
The procedure’s focus is on the surrounding natural breast tissue, not the implant itself. Studies show that implant ruptures related to mammography are exceedingly rare. Implants are more likely to fail due to aging, which weakens the shell over time, or due to trauma unrelated to the screening. If an implant is already compromised or very old, the compression could potentially worsen an existing weakness, but it is not typically the initial cause of rupture.
Specialized Imaging Techniques for Implanted Breasts
Specialized procedural adaptations are used for patients with breast implants to ensure both safety and a thorough examination. The most common technique is known as the Eklund technique, or implant displacement views. This method involves the technologist gently pushing the implant backward against the chest wall.
By displacing the implant, the surrounding natural breast tissue is pulled forward and isolated for compression and imaging. This allows the X-ray to capture a clearer image of the glandular tissue while minimizing direct pressure on the implant itself. Because the implant can obscure some tissue, four additional views are typically taken during the Eklund technique, resulting in up to eight images per breast instead of the usual four.
Identifying and Managing Potential Implant Rupture
Mammography is generally safe, but a rupture identified during the procedure usually indicates a pre-existing issue. The appearance of a rupture differs based on the filling material. A saline implant rupture is immediately noticeable as the implant rapidly deflates, with the harmless saltwater being absorbed by the body.
Silicone gel implants are more likely to experience a “silent rupture,” where the thick gel remains largely contained within the scar tissue capsule and may not cause immediate symptoms. Symptoms of a rupture can include changes in breast size or shape, increased firmness, pain, or tenderness. If a rupture is suspected on the mammogram, further diagnostic imaging is necessary.
Mammography is not the ideal tool for definitively diagnosing a minor rupture, especially a silent silicone rupture. An ultrasound is often used as a convenient first-line test to check implant integrity. However, Magnetic Resonance Imaging (MRI) is considered the most sensitive and accurate method for detecting both symptomatic and silent silicone implant ruptures. Patients who notice any lingering discomfort or changes in their breast following a mammogram should contact their physician for a follow-up evaluation.