Did you know that breast implants obscure approximately 15 to 201 TP3T of breast tissue during a mammogram? This is precisely why people who have undergone breast augmentation worry about missing cancer ahead of their regular checkups. However, there are now methods available that allow for sufficiently accurate screening even with implants present, so there is absolutely no need to worry.
In this article, I will explain step-by-step how to undergo breast cancer screenings after implant insertion, and why MRIs are particularly important. We will also look at the essential things you must check before scheduling an appointment.
Why implants obscure standard mammogram images
Breast implants do not allow X-rays to pass through, making it difficult to directly visualize breast tissue during imaging. The test results can be even more affected, particularly if the implant is located close to the mammary glands. This is also the reason behind the long-standing misconception that "breast augmentation prevents the detection of cancer.".
The good news is that medical professionals already possess techniques to address this issue. With a skilled screening team and the correct imaging methods, it is entirely possible to detect early-stage cancer even with implants present.
Pushing out implants with the Eklund technique for a clearer view
The Eklund technique is a method of taking images with the implant pushed inward.This allows for a better view of breast tissue obscured by implants. Thanks to this technique, the number of images taken increases; while standard women take a standard 4 images (2 on each side), women who have had implant surgery take a total of 8 images, with 4 additional images taken using the Eklund technique on top of the standard 4.
The accuracy of Eklund imaging is much higher when the implant is inserted under the muscle (inferior pectoralis major) than when it is inserted directly below the mammary gland. This is because the muscles make it easier to push the implant out.
Although the scanning time may be slightly longer, the probability of a normal implant rupturing during this process is extremely rare. If you are having your first examination, it is a good idea to explicitly request an Eklund scan from the medical staff in advance.
If you have capsular contracture or dense breasts, prepare additional screening methods.
If you have severe capsular contracture (hardening of the breast tissue) or dense breasts with a large amount of glandular tissue, an X-ray alone may not be sufficient. In such cases, it is important to plan for ultrasound and MRI as supplementary examinations.
Ultrasound has the advantage of clearly distinguishing lumps or masses behind the implant. It is also relatively inexpensive, and since the examination can be performed without pain, it is a comfortable choice even for those with capsular contracture.
Why MRI is called the standard for breast cancer screening
The reason medical professionals call MRI the 'Gold Standard' is that it can precisely check the condition of implants and interpret cancerous tissue. Even if there are minute cracks or leaks in silicone implants, they can be detected immediately with an MRI.
In addition, MRI shows even small cancerous tissues that are easily missed by X-ray or ultrasound much more clearly. If you have implants, it is recommended to plan a check-up that includes an MRI at least once during your regular check-up cycle (every 1 to 2 years after age 40).
Even with implants, the check-up cycle is the same as for general women, and cancer can be detected early safely by combining the Eklund technique with ultrasound and MRI.
Information you must provide to medical staff before scheduling a check-up
Advance notification is crucial for an accurate examination. Please be sure to mention these three things when calling to schedule an appointment or visiting the clinic. The first is Type of implant (whether silicone or saline)First, the second is the timing of the surgery. Third is where the implant was inserted; please confirm whether it was under the muscle or under the mammary gland and let me know.
You should also inform them in advance if you suspect any microscopic cracks or leaks. This allows the medical team to tailor the examination method accordingly. If you have capsular contracture, it is also a good idea to mention beforehand that "strong compression may be uncomfortable.".
Why It Is Better to Get Regular Checkups at a Consistent Hospital
If you continue to receive checkups at the same hospital, even subtle changes can be tracked by comparing with previous images. It also helps monitor changes in the condition of your implants, and because the medical staff understands your breast characteristics, more precise examinations are possible.
When choosing a hospital for your initial check-up, it is advisable to verify that the facility has sufficient experience and understanding of patients with implants. Use criteria such as experience with the Eklund technique, availability of MRI services, and the provision of appropriate explanations during the consultation.
| Examination method | merit | margin |
|---|---|---|
| X-ray mammography | Useful for detecting microcalcifications | Obscured by implant, tissue unidentifiable (approx. 15~20%) |
| ultrasound | Condition behind the implant is clear, no pain | Difficulty detecting microcalcifications |
| MRI | Assessment of implant rupture/leakage, most precise cancer tissue analysis | High cost, uncomfortable for those with claustrophobia |