Breast cancer screening remains a regular and important practice for women. While implants do not increase the risk of developing breast cancer, their presence changes the anatomy of the breast and presents technical challenges for imaging. Medical professionals have adapted screening protocols to ensure that mammography remains a safe and effective tool for early detection in augmented breasts. This adaptation involves both a necessary healing period following surgery and the use of specialized techniques.
Post-Surgical Waiting Period
A standard waiting period is necessary before undergoing a mammogram after breast augmentation to protect the surgical site and allow for proper healing. The recommended timeframe generally ranges from six to twelve months following the procedure. This delay ensures that post-operative swelling and tenderness have subsided, making the mammogram process more comfortable for the patient.
The primary concern with early imaging is the application of compression, which is a required part of a standard mammogram. Applying pressure to the breast tissue too soon can interfere with the formation of the implant capsule, potentially causing complications or unnecessary discomfort. The waiting period allows the implant to settle into its final position and the surrounding tissue to stabilize, which is why the plastic surgeon’s clearance is an important step before scheduling the first post-augmentation mammogram.
Specialized Imaging Techniques
When a patient with implants undergoes a mammogram, the procedure must be modified to account for the implant’s presence. It is important to inform the imaging facility about the augmentation when scheduling the appointment, as specialized equipment and a technologist with experience in this area are needed. The standard technique used to maximize tissue visualization is known as the Eklund displacement view.
This technique involves the technologist gently pushing the implant back against the chest wall while simultaneously pulling the breast tissue forward. The goal is to isolate the breast tissue in front of the implant so it can be compressed and imaged separately. This method is designed to obtain a clearer image of the glandular tissue without compressing the implant itself.
A standard screening mammogram typically involves four images, two for each breast. When the Eklund technique is utilized, the total number of images is usually doubled to eight—four standard views and four displacement views. The increased number of images significantly improves the amount of breast tissue visualized, which is otherwise obscured by the implant material. This specialized approach is applicable whether the implant is placed over or under the chest muscle.
Visualization Challenges and Supplementary Screening
Despite the use of specialized techniques like the Eklund view, breast implants can still present visualization challenges during mammography. The implant material, whether saline or silicone, is opaque on an X-ray, which can obscure or “mask” a portion of the breast tissue. This masking effect reduces the sensitivity of the mammogram, making it more difficult to detect small tumors hiding behind the implant, particularly in the posterior regions of the breast.
To overcome these diagnostic limitations, supplementary imaging methods are frequently used in conjunction with mammography. Breast ultrasound is a common, non-invasive tool used to visualize tissue directly adjacent to the implant. It is particularly helpful for evaluating palpable lumps or areas of concern that may be difficult to assess on the mammogram.
For a more detailed assessment, Breast Magnetic Resonance Imaging (MRI) is often recommended. MRI is highly sensitive and can detect cancers missed by both mammography and ultrasound, offering a more comprehensive view of the breast tissue and the implant’s integrity. While the risk of implant rupture during a mammogram is extremely rare with modern protocols, the use of cautious, specialized techniques remains important to ensure patient safety.