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Mammography can still be performed with breast implants in place. Mammography technicians are trained to use specialized techniques for women with breast implants that help to image the breast tissue around the curved surface of the implants. Be sure to let the mammography provider know that you have breast implants when you schedule your mammogram.

It is not possible to obtain a mammogram by imaging through the implants, only around them. Breast implants therefore potentially do reduce a radiologist's ability to visualize breast tissue completely. This is more of a concern with implants placed immediately behind the breast ('sub-mammary', aka 'sub-glandular' position), so for that reason the sub-pectoral position is strongly preferred.

There is no conclusive evidence which shows that women with breast implants are diagnosed with breast cancer at a later stage than women without implants - which one would expect if breast implants actually delayed the detection of breast cancer. Likewise, women with breast implants do not appear to have a higher mortality rate from breast cancer compared to women without breast implants. Breast implants do not obscure or interfere with patient self-examination or physician breast examination, which are at least as important as (if not more important than) mammography for breast cancer screening.

Mammography is currently the recommended mass screening test for breast cancer, but it has significant limitations due to a high number of false positives (which leads to biopsies when no cancer is actually present) and false negatives (which means a cancer is missed when it is present). The most sensitive and specific radiologic test for breast cancer is a contrast-enhanced MRI scan, which refers to an MRI that is enhanced by the administration of an intravenous 'contrast' agent. The contrast agent helps to 'light up' a breast cancer on the MRI scan when one is present. Breast implants do not interfere with breast MRI scanning in any way.

Michael Law