Breast Implant Controversy - Implants and Mammography

Implants and Mammography

The presence of radiologically opaque breast implants might interfere with the radiographic sensitivity of the mammograph. In this case, an Eklund view mammogram is required, wherein the breast implant is manually displaced against the chest wall and the breast is pulled forward, so that the mammograph can visualize the internal tissues; nonetheless, approximately one-third of the breast tissue remains inadequately visualized, resulting in an increased incidence of false-negative mammograms.

Breast cancer studies of women with implants reported no significant differences in disease stage at the time of diagnosis; prognoses are similar in both groups, with augmented patients at a lower risk for subsequent cancer recurrence or death. Conversely, the use of implants for breast reconstruction after breast cancer mastectomy appears to have no negative effect upon the incidence of cancer-related death. That patients with breast implants are more often diagnosed with palpable — but not larger — tumors indicates that equal-sized tumors might be more readily palpated in augmented patients, which might compensate for the impaired mammogram images. The palpability is consequent to breast tissue thinning by compression, innately smaller breasts a priori, and that the implant serves as a radio-opaque base against which a cancerous tumor can be differentiated. The implant device has no clinical bearing upon lumpectomy breast conservation surgery for patients who developed breast cancer post-implantation, and it does not interfere with external beam radiation treatments (XRT); post-treatment incidence of breast-tissue fibrosis is common, and thus an increased rate of capsular contracture.