Breast Screening with Implants

Guide to Breast Screening with Breast Implants

In this blog…

Guide to Breast Screening with Breast Implants
The Impact of Breast Implants on Screening
Preparing for Breast Screening with Implants
Breast Screening Methods and Alternatives
Choosing the Right Method
Breast Cancer Detection in Patients with Implants
FAQs about Breast Screening with Implants
Further Reading
Medical References

Whether you’re considering implants, recently had the procedure, or have been living with them for years, the importance of regular breast screening cannot be overstated. Breast cancer remains one of the most common cancers among women worldwide, and early detection is key to effective treatment and positive outcomes.

However, many women with breast implants worry about how their implants may affect the process and effectiveness of breast screening. This concern is understandable; after all, you want to ensure that your choice for breast augmentation doesn’t impede your ability to maintain your breast health. The good news is that breast screening with implants is highly feasible and effective when the right techniques are used.

The Impact of Breast Implants on Screening

Breast implants can introduce some unique challenges into the breast screening process. However, it’s important to understand that these challenges can be effectively managed with the right knowledge and techniques, ensuring that breast screening is both possible and effective for women with implants.

Screening Challenges

The presence of breast implants does not prevent you from undergoing breast screening, but it does require some adjustments to the standard procedure. Implants can obscure some breast tissue in standard mammography views, potentially making it more challenging to detect abnormalities. This is because the X-ray used in mammography may not penetrate the implant as easily as it does natural breast tissue, leading to less visible areas.

Techniques Used

To accommodate for implants and ensure a comprehensive examination, radiologists employ specialised techniques:

Eklund Technique: Also known as displacement mammography, this technique involves pushing the breast implant back against the chest wall and pulling the breast tissue into view. It allows for more breast tissue to be imaged and examined, reducing the chance of missing any abnormalities. This technique requires skilled technicians and may take slightly longer than a standard mammogram, but it significantly improves the effectiveness of breast screenings for women with implants.
Additional Imaging: In some cases, your healthcare provider may recommend additional imaging methods such as ultrasound or MRI. These methods are not hindered by the presence of implants and can provide complementary views of the breast tissue. Ultrasound is particularly useful for evaluating specific areas of concern found during a mammogram or physical exam, while MRI is employed for high-risk patients or to further investigate ambiguous areas.

Preparing for Breast Screening with Implants

Preparing for a breast screening when you have implants involves several steps to ensure the procedure is as effective and comfortable as possible. It’s not just about the day of the screening but also about choosing the right facility and understanding what information you should provide to your healthcare team. Here’s how you can prepare:

1. Selecting the Right Facility

Experience Matters: Choose a diagnostic centre or a hospital that has experience in screening women with breast implants. Facilities that regularly handle such cases are more likely to have the necessary equipment and trained staff to perform the specialised techniques required.
Certification and Recommendations: Look for a facility that is certified by reputable health organisations. Recommendations from your primary care provider or plastic surgeon can also guide you to a clinic with a good track record.

2. Informing the Clinic in Advance

Disclosure: When you schedule your appointment, inform the scheduler that you have breast implants. This is important because additional time may be needed to accommodate the special techniques used during the screening.
Specifics about Your Implants: If possible, provide details about your implants, such as whether they are saline or silicone, and their placement (behind or in front of the muscle). This information can help the radiologist tailor the screening to your specific needs.

3. Gathering Your Medical History

Documentation: Bring any relevant medical records, including details about your implant surgery. Knowing the type and placement of your implants can assist the radiologist in interpreting your mammograms more accurately.
Previous Mammograms: If you’ve had mammograms before, especially before getting implants, bring those images and reports with you. They can serve as a baseline for comparing changes over time.

4. What to Wear

Comfort and Convenience: Wear a two-piece outfit so that you only need to remove your top for the mammogram. Avoid wearing deodorants, antiperspirants, powders, or lotions on your breasts or underarms, as these can appear as white spots on the X-ray.

5. During the Appointment

Communication is Key: Before the screening starts, you’ll have an opportunity to speak with the radiologist or technician. Use this time to ask any questions and express any concerns you may have. If you experience discomfort at any point during the procedure, let them know.
Following Instructions: The technician will guide you through the process, instructing you on how to position yourself. Following their instructions closely will help ensure the most accurate imaging possible.

6. After the Screening

Results and Follow-Up: Discuss how you will receive your results and what the follow-up process will involve. It’s common to feel anxious about test results, so knowing what to expect can help alleviate some of that stress.

Breast Screening Methods and Alternatives

For women with breast implants, understanding the available breast screening methods and when each is most appropriately used is essential for effective breast health management. While mammography remains the main option for breast cancer detection, the presence of implants requires additional considerations and sometimes the use of alternative or supplementary imaging techniques.

Mammography with Implants

Mammography is a specialised medical imaging that uses low-dose X-rays to visualise the breast tissue. For women with implants, the procedure is modified to include additional views that help to visualise as much of the breast tissue as possible.

The Eklund Technique: As mentioned earlier, this technique, also known as implant displacement views, is specifically designed to work around implants. The technician will gently displace the implant towards the chest wall and pull the breast tissue forward, allowing the X-ray to capture a clearer image of the breast tissue. This technique can be slightly uncomfortable but is important for ensuring a thorough examination. It is essential to choose a facility and a technician experienced in this technique to maximise the effectiveness of your screening.

Ultrasound and MRI

In addition to mammography, other imaging methods like ultrasound and MRI can offer valuable insights, especially in cases where mammography alone is insufficient.

Ultrasound: This imaging technique uses sound waves to create images of the breast tissue. It is particularly useful for distinguishing between solid masses and fluid-filled cysts. For women with breast implants, ultrasound can provide additional information about areas that are difficult to see on a mammogram. It is often used as a follow-up test to further investigate abnormalities found during a mammogram or a physical exam.
MRI (Magnetic Resonance Imaging): Breast MRI is a more sensitive imaging technique that does not use X-rays. Instead, it uses a powerful magnetic field and radio waves to produce detailed images of the breast tissue. MRI is not typically used for routine breast screening but may be recommended for women at high risk for breast cancer or to further evaluate uncertain areas identified by a mammogram or ultrasound. For women with implants, MRI can be particularly helpful as it can also provide information about the condition of the implants themselves, such as detecting silent ruptures.

Choosing the Right Method

The choice between mammography, ultrasound, and MRI depends on several factors, including your individual risk factors for breast cancer, the presence of symptoms, and the specific concerns raised by your healthcare provider. For most women with breast implants, a combination of mammography using the Eklund technique and ultrasound offers a good approach to breast screening. MRI may be added in certain situations where more detailed imaging is necessary.

It’s important to have an open dialogue with your healthcare provider about your breast implants and any concerns you may have regarding breast cancer screening. They can help guide you to the most appropriate screening regimen for your specific circumstances.

The Importance of Regular Screening

Regular breast screening is vital for early detection of breast cancer, which can lead to more effective treatment and better outcomes. For women with breast implants, it’s important to not let the presence of implants deter you from regular screenings. With the right techniques and experienced professionals, effective breast screening is entirely achievable.

Breast Cancer Detection in Patients with Implants

Breast cancer detection in patients with breast implants doesn’t significantly differ from those without, but awareness and understanding of how implants impact the process are crucial. The goals remain the same: early detection for the most effective treatment possible.

Signs and Symptoms

Self-examination plays a vital role in early breast cancer detection, even for those with implants. Women should perform regular self-exams to familiarise themselves with their breasts’ normal look and feel, making it easier to notice any changes. Look out for:

A lump or thickening in or near the breast or in the underarm area
A change in the size, shape, or contour of the breast
A mass or lump, which may feel as small as a pea
A marble-like hardened area under the skin
Changes in the skin texture on the breast or nipple (dimpling, puckering, scaliness, or new creases)
Unexplained swelling or shrinkage of the breast, especially if only on one side
Nipple changes or discharge (not breast milk), especially if it starts suddenly or is in only one breast

Detection and Diagnosis

For women with implants, the detection and diagnosis process includes a combination of self-examinations, professional evaluations, and imaging tests tailored to account for the implants:

Clinical Breast Exams (CBE): Performed by healthcare professionals, these exams are adapted to carefully examine breast tissue around the implants.
Mammography: Utilises the Eklund technique to displace the implant and examine as much breast tissue as possible.
Ultrasound or MRI: These imaging methods may supplement mammography, especially if the mammogram results are inconclusive or if there’s a high risk of breast cancer.

After the Screening – Understanding Your Results

Understanding your results and the follow-up care needed is essential for maintaining peace of mind and ensuring any necessary actions are taken promptly.

Screening results are typically classified into categories indicating whether further evaluation is needed:

Normal: No signs of cancer were found. Continue regular screening as recommended.
Benign Findings: Non-cancerous conditions such as cysts; typically, regular monitoring is recommended.
Suspicious Abnormalities: Requires further testing (biopsy) to determine if cancer is present.
Highly Suggestive of Malignancy: Indicates a high probability of cancer, necessitating a biopsy for confirmation and treatment planning.

If your results indicate anything other than a normal finding, it’s important not to panic. Not all abnormalities turn out to be cancer.

Follow-Up Care

If your screening results suggest the need for further evaluation:

Additional Imaging Tests: May include more detailed mammography, ultrasound, or MRI.
Biopsy: A procedure to remove a small sample of breast tissue for laboratory testing. This is the only definitive way to determine if cancer is present.
Consultation with Specialists: Depending on the results, you may be referred to a breast surgeon, oncologist or other specialists for further evaluation and treatment planning.

FAQs about Breast Screening with Implants

Can breast implants increase my risk of getting breast cancer?

No, current evidence does not suggest that breast implants increase the risk of breast cancer. However, it’s essential for all women, regardless of whether they have implants, to follow recommended guidelines for breast cancer screening based on their age and risk factors. Regular self-examinations and professional screenings are key components of early detection strategies.

How soon after getting breast implants can I have a mammogram?

It’s generally recommended to wait until the post-surgical swelling has completely subsided before undergoing a mammogram. This period allows the implants to settle and the breast tissue to heal, which usually takes a few months. Always consult with your surgeon and primary care provider to determine the best timing based on your individual situation.

Will the pressure from a mammogram cause my implants to rupture?

The risk of implant rupture from a mammogram is very low. Technicians are trained to handle breasts with implants carefully, using specialised techniques to minimise pressure on the implants while still obtaining clear images of the breast tissue. If you have concerns, discuss them with the mammography technician before the procedure.

Is there a specific type of breast implant that is safer or better for breast screening?

Both saline and silicone implants are widely used and have been thoroughly researched. The choice between saline and silicone should be based on personal preference, lifestyle and the advice of your plastic surgeon. Neither type significantly hinders the ability to perform breast screenings, though the technique and interpretation of the results may vary slightly between the two.