The New Guidelines for Mammograms and Breast Self-Exams: An Interview with Three Breast Experts

The following is an article I conducted on the new recommendations and guidelines for mammograms and breast self-exams.

I interviewed three fantastic local (Bay Area) Breast Surgeons with whom I work closely on breast reconstruction cases.  Each was asked a short series of questions about their opinion of the new guidelines, and how their practice may be affected. 

Read on! (click on each page for a larger, more clear version of the magazine text)

The interview is published in the Junior League of San Francisco's Fogcutter Spring 2010 publication.

Breast Implants and Mammograms - Breast Cancer Detection is Safe!

CPMC and Sutter Health's

MyLifeStages "Ask the Expert"

Question & Answer

Question:

I'm a 40-year-old woman considering modest-sized breast implants. Will they interfere with the ability to detect breast cancer?

Answer:

Karen Horton, MD, MSc, FRCSC

Expert

Karen Horton, MD, MScPlastic and Reconstructive SurgeryCalifornia Pacific Medical Center

Dr. Karen Horton is one member of a unique all-woman Plastic Surgery practice in San Francisco. She specializes in breast reconstruction after cancer and cosmetic surgery for women. She is one of very few Micro-surgeons performing state-of-the-art reconstructive techniques for the breast, including the DIEP flap, SIEA flap and TUG (inner thigh) free flap. Dr. Horton regularly performs “mommy makeover” surgery to rejuvenate the breasts and bodies of women who have completed childbearing. Visit www.womensplasticsurgery.com for more information.

See Dr. Horton's profile

Plastic and Reconstructive Surgery

California Pacific Medical Center

Breast augmentation using implants will not interfere with breast cancer detection. Implants of all shapes and sizes have a shell made from silicone, which is an inert solid and is used in many implantable devices. The fill can be either saline (sterile salt water) or silicone gel. Sizes range from 125 cc to 800 cc, and implants may be smooth-walled or textured, round or shaped.

Breast implants are placed either behind the breast tissue (subglandular position) or behind the breast tissue and the pectoralis major muscle (submuscular position). There are proponents for each technique, based on opinion and surgical training. Regardless of the placement of the implant, the fill material and the size, having breast implants does not interfere with breast self-examination, physician breast exams, mammograms, ultrasound, MRI or any other cancer detection techniques.

When having a mammogram, women should inform the mammography technician that they have breast implants in place. A “displacement” technique will be done to help push the breast tissue off the implant and to allow the X-ray beams to shoot through the breast to accurately visualize the tissue. Occasionally, additional views are taken when an implant is in place.

Mammograms are generally not recommended until age 40, as before this age breasts are quite dense and visualization is not reliable. A 40-year-old woman should have a mammogram as a baseline exam before considering any surgery of the breasts, including augmentation, reduction or a breast lift.

Two studies in the literature actually showed that women with breast implants had earlier detection of breast cancer than those without implants, perhaps because the implant served as a surface against which a lump was palpated (felt) during breast self-examination.

Having breast augmentation is a personal choice and should be researched in detail before you commit to any surgery. Make sure you consult with a Plastic Surgeon who is Board-Certified and experienced in the procedure you are seeking.