Mammography is a fundamental tool in the early detection of breast cancer. For individuals with breast implants, it is possible and highly recommended to undergo mammograms. Continued screening is important for early detection, which can lead to more effective treatment outcomes.
Mammography and Breast Implants
Breast implants, whether filled with saline or silicone, present a unique challenge for mammography because they are opaque to X-rays. This opacity means the implants can obscure natural breast tissue, making it more difficult for radiologists to detect abnormalities.
Technologists employ specific techniques to move the implant out of the imaging field. The primary goal is to visualize as much breast tissue as possible, particularly the tissue behind and around the implant. An experienced mammography technologist is important for performing these specialized views accurately. Their expertise helps ensure that adequate breast tissue is captured for examination.
Specialized Mammography Views
For individuals with breast implants, mammography typically involves more images than a standard screening. While the standard craniocaudal (CC) and mediolateral oblique (MLO) views are performed, additional images are crucial. These extra images are known as implant displacement (ID) views, also referred to as Eklund views. In these specialized views, the breast tissue is gently pulled forward from the implant.
The implant is carefully pushed back against the chest wall, allowing for better compression and visualization of the natural breast tissue in front of it. This technique aims to capture breast tissue that would otherwise be hidden by the implant. Typically, four extra images are taken, two of each breast, in addition to the standard four views, resulting in a total of eight images. While standard views are taken with lighter compression to prevent implant rupture, implant displaced views allow for normal compression of the breast tissue.
Additional Screening Options
Beyond mammography, other imaging modalities can supplement or serve as alternatives for breast cancer screening. Breast ultrasound is frequently used to evaluate tissue around the implant or to investigate areas that mammography might not fully visualize. This method uses sound waves and does not involve radiation, making it beneficial for imaging dense breast tissue. It can also help assess fluid collections or other changes near the implant.
Magnetic Resonance Imaging (MRI) of the breast is another valuable tool, offering high sensitivity for detecting breast cancer and evaluating implant integrity. MRI is particularly useful for detecting “silent ruptures” in silicone implants, which may not be visible on mammograms. It may be recommended as part of a high-risk screening protocol or to further investigate findings that are unclear on mammograms or ultrasounds.
Key Considerations for Patients
Patients with breast implants should inform the mammography facility and technologist before their appointment. It is helpful to mention this when scheduling the appointment to ensure the facility has experience with implant mammography. Choosing a facility with technologists and radiologists experienced in imaging breasts with implants can contribute to obtaining the best possible images.
While compression is part of the mammogram process, the risk of implant rupture during a mammogram is very low. Technologists are trained to gently position the breast and implant to minimize risk. If discomfort or pain occurs during the procedure, communicating this to the technologist is important so adjustments can be made. Discussing any concerns about mammography or breast health with a healthcare provider is always recommended.