Misconceptions about mammograms among women with breast implants may place their health at risk, say doctors at UT Southwestern Medical Center at Dallas.
Women who have undergone augmentations are less likely to have yearly mammograms because they assume implants interfere with the detection of breast cancer or that the procedure will cause their implants to rupture, said Dr. Phil Evans, who leads the breast imaging program at the Southwestern Center for Breast Care.
More than 206,000 women underwent breast augmentation procedures in the United States last year -- a 533 percent increase since 1992 -- so it's important to clear up the misunderstanding about mammogram guidelines, said Evans, professor of radiology, especially since October is Breast Cancer Awareness Month.
"Mammography is the single most important method for detecting breast cancer and reducing mortality," he said. "All women, including those with breast implants, who are 40 and older should have an annual mammogram and breast examination by a health-care professional and perform monthly breast self- exams."
According to the American Cancer Society, mammograms reduce breast cancer mortality by 66 percent.
Silicone- and saline-filled implants, which are encased in a silicone shell, create an opaque image on an X-ray. To get a better view of the breast tissue in women with implants, radiologists take twice as many views - four of each breast.
During a standard mammogram, the breast is compressed between two plates to spread the tissue apart and accurately image the breast tissue.
"For women with implants, we use a special technique, known as implant-displaced views, to mobilize the implant away from the breast tissue," said Evans. "The implant is pushed back against the chest wall, and the breast tissue is pulled forward. This allows more breast tissue to be imaged than with the routine views."
Dr. Rod Rohrich, chairman of plastic surgery at UT Southwestern, performs about 100 breast augmentation procedures every year. He routinely reminds his patients who are 40 and older about the importance of mammograms in detecting breast cancer.
"Most breast implant patients are reluctant to undergo a mammogram because they worry that the pressure will cause their implants to rupture," said Rohrich. "It is rare to have an implant rupture during a mammogram."
Evans agreed, saying he has never had an implant rupture during a mammogram exam in his 27 years in practice.
"The possibility of a rupture shouldn't deter women from having a mammogram," he said. "They should concentrate on the fact that a mammogram may detect breast cancer at an early stage."
Evans said that from a radiologist's perspective, implants placed behind the chest wall allow better imaging of the breast tissue.
Women who have had their breasts augmented can still perform monthly breast self-exams as well.
"Regardless of the placement of the implant, women can still do self-exams. It is important for women to become familiar with their breast tissue and report any persistent changes to their physician," Evans said.
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