Mammography, a specialized X-ray of the breast tissue, is a procedure that women with breast implants should continue to receive for cancer screening. The presence of a breast implant, whether filled with saline or silicone gel, necessitates modifications to the standard examination. Neither cosmetic nor reconstructive implants prevent the use of mammography as the primary method of early breast cancer detection.
Specialized Imaging Techniques
The standard mammogram procedure is adapted significantly when breast implants are present to ensure maximum tissue visibility. This modification is known as the Eklund technique, or implant displacement views, which is an internationally recognized method for screening augmented breasts. Instead of the standard four images, a full screening typically involves taking eight separate views: four with the implant included and four with the implant displaced.
This displacement involves the technologist gently pushing the implant backward toward the chest wall while carefully pulling the natural breast tissue forward. This maneuver isolates the breast tissue from the implant, allowing it to be compressed and imaged without the implant obscuring the view. This specialized compression technique is performed with sensitivity and skill, and it carries a low risk of implant rupture. The procedure takes slightly longer than a routine mammogram, but it optimizes the visualization of the glandular tissue for a reliable examination.
Impact on Cancer Detection Rates
Despite the use of specialized techniques, the physical presence of an implant can introduce limitations to the diagnostic effectiveness of a mammogram. The implant occupies space and can obscure the underlying breast tissue, potentially hiding a small developing tumor. This obstruction lowers the overall sensitivity of the screening compared to a non-augmented breast.
The composition of the implant filler also plays a role in image quality. Silicone implants are filled with a dense, radiopaque gel that blocks X-rays more effectively than natural tissue, creating a significant visual barrier. Saline implants, which contain a saltwater solution, are generally more transparent to X-rays, causing less visual interference than silicone gel implants.
Complementary Screening Tools
Because mammography alone may not provide a complete view of the breast tissue in augmented patients, additional imaging modalities are often used to supplement the annual screening. Breast ultrasound is a common complementary tool that uses sound waves to create images of the breast tissue surrounding the implant capsule. It is particularly useful for evaluating obscured areas or investigating specific concerns identified during the mammogram.
Magnetic Resonance Imaging (MRI) is considered the most sensitive tool for detecting cancer in augmented breasts, and it is the gold standard for assessing the integrity of silicone implants. The Food and Drug Administration recommends that women with silicone gel-filled implants undergo screening with MRI or ultrasound five to six years after the initial surgery, and then every two to three years thereafter. These supplementary tests provide a more comprehensive approach to screening and breast health monitoring.