From the Guidelines
Yes, it is generally safe to have a mammogram with breast implants, and regular mammograms are still recommended for women with implants according to standard screening guidelines. You should inform the facility in advance that you have implants so they can prepare accordingly. The technologist will need to take special care and additional images to visualize as much breast tissue as possible, using a technique called implant displacement views 1. This involves gently pushing the implant back against the chest wall while pulling the breast tissue forward for imaging. While mammograms with implants may be slightly less sensitive at detecting abnormalities because implants can obscure some breast tissue, they remain an important screening tool 1. You might experience slightly more discomfort during the procedure compared to women without implants, but serious complications like implant rupture are rare.
Some key points to consider:
- Mammography can identify extracapsular silicone, which presents as high-density material outside the confines of the implant shell 1.
- Mammography does not detect intracapsular silicone implant rupture, but it can be useful in detecting extracapsular silicone 1.
- The diagnosis of silicone implant rupture can be challenging, with clinical examination known to be unreliable, and mammography may be used to evaluate for rupture in symptomatic patients 1.
- Breast cancer screening recommendations for feminine and transfeminine patients are outlined in the ACR Appropriateness Criteria topics on “Breast Cancer Screening” and “Transgender Breast Cancer Screening” 1.
It's essential to follow standard screening guidelines and consult with a healthcare professional for personalized advice on breast cancer screening with implants.
From the Research
Mammography with Breast Implants
- Mammography can be used in women with breast implants, but its sensitivity and specificity may be lower compared to other imaging modalities such as MRI 2, 3.
- The presence of breast implants can make it more challenging to interpret mammography results, particularly in women with dense breast tissue 2, 3.
- Contrast-enhanced mammography (CEM) has been shown to be a feasible alternative to MRI for women with breast implants, with high sensitivity and specificity 4.
Alternative Imaging Modalities
- MRI is considered a more sensitive and specific imaging modality than mammography for detecting breast cancer, particularly in women with dense breast tissue or breast implants 2, 3.
- Ultrasound can be used in combination with mammography to improve detection rates, particularly in women with dense breast tissue 5.
- The combination of mammography and ultrasound has been shown to detect more breast cancer cases than mammography alone, particularly in women with dense breasts 5.
Considerations for Women with Breast Implants
- Women with breast implants should discuss their individual risk factors and imaging options with their healthcare provider to determine the best screening strategy 4, 6.
- The use of CEM or MRI may be considered as an alternative to traditional mammography for women with breast implants, particularly those with dense breast tissue or a high risk of breast cancer 4, 6.