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Breast cancer detection in women with implants has been questioned. We sought to evaluate the impact of breast implants on mammographic outcomes. A retrospective review of women undergoing mammography between March 1 and October 30, 2013 was performed. Demographic characteristics and mammogram results were compared between women with and without breast implants. Overall, 4.8 per cent of 1863 women identified during the study period had breast implants. Median age was 59 years (26-93). Women with implants were younger (53.9 vs 59.2 years, P < 0.0001), had lower body mass index (25.4 vs 28.9, P < 0.0001), and were more likely to have dense breast tissue (72.1% vs 56.4%, P = 0.004) than those without. There were no statistically significant differences with regards to Breast Imaging Recording and Data System 0 score (13.3% with implants vs 21.4% without), call back exam (18.9% with vs 24.1% without), time to resolution of abnormal imaging (58.6 days with vs 43.3 without), or cancer detection rate (0% with implants vs 1.0% without). Because implants did not significantly affect mammogram results, women with implants should be reassured that mammography remains useful in detecting cancer. However, future research is required to determine whether lower call back rates and longer time to resolution of imaging findings contribute to delays in diagnosis in patients with implants.
BREAST AUGMENTATION IS presently the most popular cosmetic surgical procedure performed in the United States.1, 2 In the 2013 Plastic Surgery Statistics Report, the American Society of Plastic Surgeons reported an increase in breast augmentations performed in the United States between the years of 2000 and 2013 from an estimated 212,500 to over 290,000.1 The increase in number of breast augmentations performed has prompted a subsequent rise in concern over the effect that implants may have on mammography. The radiopaque quality of breast implants has been shown to obscure breast tissue imaging by mammography, which consequently makes imaging with mammography more difficult and potentially delays the diagnosis of breast cancer.3-7 Radiologists uses a technique called implant displacement views, first described by Eklund, that takes an additional four images to optimize the amount of breast tissue viewed on mammography by pushing the implant posteriorly and pulling the breast tissue over the implant.5-7 Additional studies have argued against the...