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Do breast implants hinder cancer screening?

Breast augmentation is a lifetime decision, and so the question of how implants may affect the diagnosis of cancer needs to be considered regardless of the age of the patient at the time of the original surgery. We inform breast implant patients that their implants may make detection by mammography more difficult, because X-rays don’t “see” through implants and may hide a suspicious spot. But how much does this interfere with cancer detection?

 

The issue that has been studied fairly extensively, and the results are reassuring overall. First, it is important to point out that there is no evidence of breast implants being associated causatively with breast cancer (in fact most studies show a lower rate of cancer in augmented patients), so the real question is how they might interfere with mammography or self-exam. The fear is delayed diagnosis of cancers that might have been curable had they been discovered earlier.

 

One of the better studies on the subject is from the Keck School of Medicine at the University of Southern California, published in Plastic & Reconstructive Surgery in 2007. This comprehensive review article concluded that “using indicators such as stage at diagnosis and tumor size, current research shows that augmentation patients do not experience delayed detection” and “these patients do not experience delayed detection or poorer post-breast cancer survival.” A subsequent study from Canada, comparing a large number of women with implants to a control group with other types of plastic surgery, found that although the stage at diagnosis was slightly higher, there were no differences in survival. (Note: this blog was originally published in 2010, but I have not found any recent studies contradicting those conclusions.)

 

Mammograms do need to be done with special techniques on women with implants, but they still need to be done. And with several hundred thousand women receiving implants every year in the U.S., there aren’t any radiology centers that haven’t seen them and lack the ability to do the test properly. As for self-exam, because the implant is always behind the breast tissue, there should be no difficulties and no excuses!

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