• Breasts Exams After Implants – A Guide to Self Exams and Mammograms

    breastexam

    Awareness about breast cancer, its symptoms and the importance of early detection is at an all-time high thanks to efforts by the American Cancer Society and organizations like the Susan G. Koman foundation. As a doctor, I’m thrilled to see so many of my patients taking an active role in their own health care.

    As a plastic surgeon, I am often asked by breast augmentation patients about how the implants will effect their chances of getting breast cancer and if the implants will interfere with self breast exams or mammograms.

    Do Breast Implants Increase the Risk of Breast Cancer?
    Will Breast Implants “Hide” Lumps or Make Self Detection More Difficult?
    What About Getting a Mammogram with Breast Implants?

    Do Breast Implants Increase the Risk of Breast Cancer?
    In short, no. Breast implants are the most studied medical device in history. The FDA and plenty of other research entities have spent years monitoring breast implant and breast cancer correlation figures, and they just aren’t there.

    From the Susan G. Komen web site:
    “Although there has been some debate in the past, there is no scientific evidence to show that either saline or silicone breast implants increase breast cancer risk. Findings from prospective cohort studies and a meta-analysis of 10 studies of cosmetic breast implants (including studies of both saline and silicone implants) have found no increase in breast cancer risk among women with breast implants.
    A few studies have shown a lower risk of breast cancer among women with implants. However, this is most likely due to traits of women who tend to choose breast implants, such as a lower body mass index. These factors lower risk for breast cancer rather than the implants themselves.”

    Will Breast Implants “Hide” Lumps or Make Self Detection More Difficult?
    Many of my patients start doing self breast exams starting in their 20s and 30s, and they sometimes ask me about the difficulty of performing breast self-exams with breast implants. They are often worried that the implants will hide lumps or make them impossible to feel.

    In terms of anatomy, breast implants actually tend to HELP with self breast exams.  Most breast implants are placed under the muscle while some are placed above the muscle.  In either case, the breast implant pushes the breast tissue FORWARD, or away from the rib cage. This allows you, as the lucky women with breast implants, or the lucky significant other doing hourly breast exams, to “feel” the breast tissue and feel any potential lumps a little easier.

    There is no breast tissue “hiding” behind the implant.  In a submuscular implant placement, the only thing behind the implant is the rib cage. When the implant is inserted on top of the muscle, the only thing behind the implant is the pectoralis muscle and the rib cage. In either case, the breast tissue (where cancer cells can grow) is on top of the implant.

    Going from the outside in with a breast implant placed UNDER the muscle, the layers are as follows:
    Skin/ areola/ nipple
    Breast tissue
    Muscle/ Pectoralis Muscle
    BREAST IMPLANT
    Chest Wall/ Rib Cage
    Lungs/ Lung Cavity/ Pulmonary Cavity

    Going from the outside in with a breast implant placed ABOVE the muscle, the layers are as follows:
    Skin/ areola/ nipple
    Breast tissue
    BREAST IMPLANT
    Muscle/ Pectoralis Muscle
    Chest Wall/ Rib Cage
    Lungs/ Lung Cavity/ Pulmonary Cavity

    What About Getting a Mammogram with Breast Implants?
    Regarding mammogram, the breast implant also makes the breast tissue go forward, and thus the possibility of seeing any potential lesions can be accommodated as well.  Make sure to tell the mammogram technician that you have breast implants, and he/ she will be able to accommodate your breasts in the mammogram machine. Don’t worry, the compression generated by a mammogram is not enough to cause a rupture or leak in saline or silicone implants.

    Interestingly, studies in geeky plastic surgery journals that only plastic surgeons read have shown that women with breast implants have a HIGHER rate of compliance with mammograms.  They actually don’t know why-  but the speculation is that since this group of women care enough about their breasts to get them augmented, they care enough to make sure that they get mammograms when they’re supposed to, compared to women with natural breast tissue.

    Your should talk to your family doctor about when you should get a mammogram. Guidelines differ based on your personal health history, your family history of relatives who have had breast cancer, and ACS/ America Cancer Society recommendations versus the Federal Government. If you happen to live outside the USA, then your country’s guidelines may differ from USA recommendations. You can rest assured that most mammogram technicians can get a great picture of your breast tissue with a mammogram.

    I wrote an article regarding mammograms and breast implants in 2010, which can be read here.

    So as you can see, when it comes to breast implants and breast cancer, there is lots of good news. Your risk of cancer will not be higher with breast implants and finding unusual lumps early may even be easier with breast implants. PLUS, you get to look great and have lots of fun shopping for new bras, clothes and bathing suits.

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