Breast implants are best placed in the submuscular or partially submuscular plane. This means you will still be able to have mammograms, MRI's etc. Plastic surgeons are also generally good doctors. Most would not want to risk your health. Thus, they are as interested in a good long term outcome as you are. So you will still be able to feel lumps and bumps, but be sure to keep a close relationship with your doctor for good breast health. Good luck!!

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.

Thank you for your inquiry regarding postings on DoctorBase, and yes I will be happy to share my thoughts on the submitted questions.

Do breast implants make it harder to detect breast cancer lumps?

The response to this question really depends on implant location and type of implant that is used. With the addition of tangential and oblique views, generally speaking there is minimal obscuring of the breast tissue by breast implants.

The incidence of breast cancer in implanted patients has been studies really extensively since about the 1960’s. There is no evidence of any increased incidence of the typical breast cancers in implanted patients. As a matter of fact, some researchers feel that the walls of the implant act as a mild antigenic stimulant to the breast tissue, therefore potentially reducing the incidence of breast cancer in the implanted population. Of course if the referring physician feels it indicated, there are very accurate studies of the breast tissue, namely MRI that can look at the tissue millimeter by millimeter.

In response to the second question “I have breast cancer in my family and am considering getting breast implants.”

The familial genetic incidence of breast cancer would be determined by a workup known as BRCA1 and BRCA2. If in the unlikely event that a patient might be genetic positive with a predisposition for breast cancer, I would generally spend a great amount of time counseling this particular individual. Here in Houston, we would refer these patients to the Baylor College of Medicine Lester and Sue Smith Breast Center to get an absolute handle on the genetic predisposition if indeed there is a BRCA1 and BRCA2 positivity. We would then make a decision with the patient and the staff at the Baylor College of Medicine regarding breast implants. It is not uncommon for a patient to have a relative with breast cancer, and generally, unless the patient has a genetic predisposition, this would not contraindicate breast implants.

Franklin A. Rose, MD

http://www.plasticsurgeryrose.com/

There are studies that suggest that having breast implants "mask" that ability to see all of the breast tissue by up to 15%. Mammographers are now very good at obtaining additional views as needed to decrease this percentage. Also, I believe that having breast implants increases the likelihood of finding a lump earlier on self exam because the implant distributes the breast tissue over a larger area and serve as an even platform for feeling lumps. This I think outweighs the possible masking effect of the implants on mammography

Remember to do a self breast exam monthly between menstrual cycles. This is best done in the shower with soap starting at the nipple and moving outward in a methodical circular motion and then in a up and down and side to side motion. Those that have lumpy breasts are looking for changes in those lumps. When in doubt, always check with your primary care physician.

It is important that you have a screening physical exam and test (mammogram, ultrasound or MRI) prior to having breast augmentation. With imaging, breast cancer can be detected before they even form a lump. Some of the breast tissue may not be visible on the images even without an implant. In general women who have breast implants have tendency to have their breasts checked more often. But if having implants in makes you worried all the time, don't do it.

For the best answer you need a formal in person consultation with a board certified plastic surgeon. Generally speaking breast implants placed under the chest muscle that remain soft and do not have scar tissue called capsular contraction provide the best opportunity for adequate mammograms. Breast implants placed on top of the muscle under the breast that develope capsular contraction can interfere with mammograms

There was a large study done that showed no increase in the risk of breast cancer, no later stage at detection, and no change in survival rates. Getting breast implants can affect the amount of breast tissue that is visible on mammogram, but placing them under the muscle minimizes this, and it's a small percentage anyway.

Several large studies at major institutions revealed that breast implants placed in the sub muscular position did not make it more difficult to detect breast cancer. However, breast implants placed in the submammary position i.e. above the muscle, did make it more difficult to detect breast cancer. Remember, breast self-examination and appropriate age and timing of mammograms and frequent examination of your breasts by your OB/GYN are imperative. Also, knowing your family history is important and you may want to know your BRCA Status if there is a positive family history of breast cancer. One in eight women develop breast cancer. Personally, I have perform breast augmentation in the sub muscular position and two of my patients developed breast and since the breast implants were under the muscle they did not have to be removed and the women retained the shape of their breast even after the modified mastectomy. Breast augmentation is an important decision and should be discussed in detail with your plastic surgeon cooperating with your OB/GYN surgeon. Best of luck in your endeavors.

I take care of breast cancer patients every everyday practically. There is no study that states that implants lead to more issues with breast cancer. A proper set of mammograms at a center that is accredited by the American College of Surgeons is an excellent way to be evaluated. After that the modalities like ultrasound and MRI can be used to address any other questions.