Mammography and breast implants

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Robert Maurer
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Mammography and breast augmentation

Mammography is also the most effective early diagnosis tool for breast cancer for women who wear breast implants.
First of all, it should be noted that there is no correlation between prosthesis insertion and breast cancer.
In case there are indirect risks, linked to the inexorable phenomena of wear that the prostheses undergo with the passage of time. The disintegration of the external envelope can lead to leakage of prosthetic material, triggering, in some cases, an exaggerated immune response. Some authors even hypothesize an indirect relationship between the release of prosthetic polymers and the development of breast tumors. However, these hypotheses are not supported by reliable data and dependent on the type of prosthetic material used. It is no coincidence that research is focusing on the study of natural substances which, in the event of a leak, are completely harmless to the body.
What is certain is that modern prostheses are equipped with a double external membrane capable of preventing the leakage of material if the most superficial layer is damaged.



However, the insertion or presence of breast implants can adversely affect diagnostic tests such as mammography and palpation.
In reality, a lot depends on the type of prosthesis implanted and its location.                         
The most recent prostheses, for example, are radiolucent and can be freely crossed by X-rays without obscuring the underlying breast tissue. In these cases the diagnostic efficacy is comparable to that conducted on a natural breast.
The oldest implants are instead formed by radiopaque polymers that reduce the explorability of the underlying tissues, hindering in some cases the early discovery of a breast cancer. In these situations, standard screenings are not sufficient to fully investigate the breast parenchyma and diagnosis becomes more difficult.
The radiodensity of the prostheses therefore depends on the type of material used and its physical characteristics. Before undergoing breast augmentation surgery, it is therefore useful to scrupulously examine the characteristics of the prosthetic material by asking the plastic surgeon who will perform the surgery for detailed information.



The placement of the prostheses also heavily influences the diagnostic effectiveness of mammography. If the implant is inserted completely submuscularly (below the pectoral muscle), mammography does not require special precautions and the radiologist will have no difficulty in carrying out his investigation.
On the contrary, if the prostheses are inserted in the subglandular area, that is positioned above the pectoral muscle, the mammographic examination will be less easy.
In any case, it is necessary to inform the staff before the start of the diagnostic procedures. In fact, there is a specific methodology which, in the case of subglandular implantation, provides for multiple projections of the breast in order to examine the breast tissue in all its points.
This technique allows to obtain good results even if the prostheses are built with radiopaque materials. However, it is not without contraindications since the greater number of scans performed increases the absorbed radiation dose. However, these are exposures well below the maximum limits that normally do not involve any risk for the patient.
It should also be considered that excessive pressure exerted on the breast during the examination could potentially damage the implants. Also for this reason it is advisable to contact accredited centers, informing the radiologist in advance about the presence of prostheses.

Finally, it should be remembered that the prosthetic material does not interfere in the least with other diagnostic tests such as ultrasound and magnetic resonance imaging. This last technique offers greater reliability and represents the safest means for the study of the breast with prosthesis.


Breast augmentation and self-examination

Generally, women with a breast prosthesis tend to ignore the presence of lymph nodes much more than others, both for fear of damaging the prosthesis and for the objective difficulty in distinguishing the breast tissue from the prosthetic one.
However, the plastic surgeon who performed the surgery can provide useful information to help the patient identify any nodules.



One last tip

The analysis of the diagnostic efficacy of mammography and self-examination in the presence of breast implants has repeatedly led us to underline the importance of choosing specialized centers and qualified personnel. It is therefore necessary to pay the utmost attention in the choice of structures and staff assigned to the intervention. It is a wise rule of conduct to inquire in advance, doubting who applies too low rates and asking concrete reasons for those who apply too high.



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