Breast Augmentation and Breast Cancer Screening

Kelly Biggs, MD

Women with breast implants for augmentation should undergo annual screening mammography, just as women without implants. Both silicone and saline implants appear bright on a mammogram, and therefore can obscure a breast cancer. Because of this, women with breast implants will have a greater number of images taken of their breasts compared to women without implants. In addition to the two standard views acquired of each breast with any mammogram, those with implants will have two additional displaced views of each breast taken. For these images, the implant is displaced away from the native breast tissue by the technologist so that only breast tissue is seen. This combination permits the radiologist to assess the implant as well as the maximum amount of breast tissue possible. While the radiation dose is higher than a routine screening mammogram, the dose remains negligible as a significant risk factor.

Rupture of an implant is possible with mammography but exceedingly rare. Women should not forego screening mammography based on this risk, as it is far less than the risk of developing breast cancer. The risk of implant rupture is also possible when a breast biopsy is performed. This risk is also low as the implant is usually easily avoided by use of medical imaging during biopsy. When integrity of a silicone breast implant is in question, rather than breast cancer screening, the imaging modality of choice is magnetic resonance imaging (MRI). MRI is very good at assessing implant rupture or other degradation that may not be evident by mammogram.