Find all kinds of information about Breast Implantation to make your decision easier.

Mammograms and Breast Self-Examination

Introduction: Mammograms Can Save Your Life

Frequently Asked Questions

Mammogram and X-Ray Films With Breast Implants

Mammogram Films Without Breast Implants

How to Perform a Breast Self-Examination (with or without implants)

Magnetic Resonance Imaging and More

The Least You Need to Know

Introduction: Mammograms - It Can Save Your Life

I don’t know anyone who enjoys having a mammogram down. We don't have to like it, but if you are considering having breast implants, you should have them done before your surgery if you are 35 or over or have a family history of breast cancer. You should also continue having annual mammograms after your breast augmentation surgery.

Why? Simple: breast cancer kills. Breast cancer is second only to lung cancer as the leading cause of cancer death in American women. Statistically, 1 in 8 women will have breast cancer sometime in their lives and 1 in 33 will die of it.

If you are not getting breast implants, you usually don't have to get a mammogram until age 40, unless breast cancer runs in your family. Mammography may have improved since the 1950s, but it hasn’t improved enough. The plates are still colder than we'd like, the act of compression is no picnic, and some mammogram technicians aren't that sympathetic. Still, mammography is the best way to help detect breast cancer in its earliest and most treatable stages.

Over the years, there have been many controversies and disagreements over how best to screen for breast cancer. The recommendations for screening change occasionally and some cancer advocacy groups make different recommendations. This can be confusing, but everyone agrees that the three key steps to detecting breast cancer early are regular mammography, regular clinical breast examinations by a trained health professional, and knowing what your breasts normally look and feel like so that you can spot changes.

The American Cancer Society (ACS) has issued guidelines for screening for breast cancer. It recommends that all women over age 40 have a mammogram every year. Mammograms are not foolproof, but they are still an excellent way to detect breast cancer. Women in their 20s and 30s should have a clinical breast exam (an exam by a health professional) every three years and women over age 40 should have one annually.

All women should also become more aware of their breasts and how they feel and look. Breast self-examinations (BSEs) are a good way to do this. At one time, the ACS strongly recommended that all women perform a breast self-examination every month. ACS no longer strongly recommends Breast self-examination anymore. The group also recommends that if you choose to perform a breast self-examination regularly, have your doctor or a nurse check your method to make sure you are doing it right.

On the other hand, Susan G. Komen for The Cure, possibly the leading advocacy group dedicated specifically to breast cancer, still recommends that women start performing a BSE every month at age 20, in addition to mammography and clinical breast examinations.

The most important thing is to know what your breasts look like and feel like, If you see any of the following symptoms, see your doctor right away:

Swelling
A lump
Skin irritation
Dimpling
Pain in the nipple
A turning inward of the nipple
Redness or scaliness of the nipple or breast skin
Discharge from the nipple other than breast milk

If you have a family history of breast cancer, discuss this with your gynecologist or plastic surgeon before having breast implants. If you are at high risk of having breast cancer, you should consider starting to have mammograms earlier and having more frequent tests.

By the way, men can get breast cancer, too. About 1% of all cases of breast cancer occur in men and it may not be diagnosed until later than in women because men are not aware of it.

Mammograms and Breast Implants

Although most women do not need to have a mammogram before age 40, you may be asked to have one no matter what you age if you are planning to have breast augmentation with breast implants. Basically, this is done to ensure that your breasts are healthy and that there are no problems and to create a baseline mammogram that future ones can be compared with.

If you have breast implants, you still need to have regular mammograms. You also must understand that the implants may interfere with early detection of possible cancerous changes in your breasts. Although there are mammography techniques that will be used to image as much of your breast tissue as possible, there is still the possibility that a tumor may be missed at its early stages because of your implants. You will be asked to undergo more views of your breasts during your mammogram to reduce this possibility.

Because mammography requires that your breast be compressed, there is the possibility that it can cause breast implants to rupture. You will more than likely be asked to sign a waiver telling you of this risk before your mammogram. The technician must be told that you have breast implants so that extra care can be taken to reduce the risk of rupture (as well as to ensure that special techniques are used and extra views of the breast taken). The special techniques are called Eklund displacement or breast displacement views.

Because it takes longer to perform mammograms on women with breast implants, make sure to tell the clinic that you have them when you are making your appointment.

Frequently Asked Questions About Mammograms

Why get a mammogram?
Because it could save your life! Seriously. According to the American Cancer Society, despite advanced technology and increased awareness, breast cancer is still the second-leading cause of cancer-related deaths in women. Mammograms can detect lesions even way before you or your doctor can feel a lump. Early detection means a much, much greater chance of curing cancer. It is just that simple. Any type of cancer has a higher chance of being beaten when nipped in the bud, so to speak.

How often should I get a mammogram?
If you are over age 40, you should get a mammogram about once a year. You don't have to like it, but you really should do it. If you have a strong family history of breast cancer—a mother, grandmother, or sister who had it—your doctor may advise you to start having mammograms earlier. This is especially true if a close relative had breast cancer at a young age.

How does a mammogram work?
Basically, a mammogram is an x-ray of the breast, however it is a specialized type of x-ray that uses lower energy x-rays that do not penetrate tissue as easily as x-rays used for checking for broken bones. The lower energy of the x-rays improves the contrast in the image.

During a mammogram, you will be standing and positioned so that your breast is resting on a flat clear plastic plate. A second plate will be adjusted so that your breast is compressed tightly. The tight compression keeps the breast from moving and helps create a sharp image on the x-ray. Usually, each breast is x-rayed from two-different positions. The films are then sent to a radiologist (a medical doctor who specializes in interpreting x-rays) to be read.

Usually, you will be asked to wait in the room while the technician takes a quick look at the films to ensure that they are clear. Occasionally, you may need to have another view taken. Then you get dressed and go on your way.

Will I get cancer from a mammogram?
Modern mammography system uses very low doses of radiation to make really detailed images of your breasts. To give you an idea of just how low the radiation dosage in mammography is, usually the dosage is around 0.1 to 0.2 rads (a unit of measurement for radiation). A cancer patient undergoing radiation treatment often times receives anywhere from 1000 to 7000 rads or more. The risk of developing cancer from mammography is very, very tiny and is greatly outweighed by the benefit of early detection.

If you have breast implants, you will need several different views of each breast instead of the usual two views per breast. This means you will get a larger dose of radiation compared to someone without breast implants.

Be sure that your mammography clinic is accredited by the American College of radiology (ACR). This will assure you that they have the highest quality of mammography equipment and technicians.

Does having a mammogram hurt?
Most women say that having a mammogram is awkward, uncomfortable, and that they feel a little violated afterwards, but most also say that it can hurt somewhat. If you should have sharp pains or intolerable discomfort during mammography, tell the technician right away.

Many women experience tenderness in their breasts during certain times of their menstrual cycle. Try to schedule your mammogram during a time of the month when you are less tender. Some women say that stopping caffeine intake a couple of days before the mammogram helps decrease discomfort.

The biggest fear of patients about mammograms is the compression. Yes, your breasts will have to be compressed and there is no getting around that. It has to be done though to get a proper view of the breast and to immobilize it to reduce any blurring on the film.

Is there anything I should do or not do before my mammogram?
Do not wear any lotions, talcum powder (talc), perfumes, sprays, deodorant, etc. Go to your appointment au natural (except for your clothes). These products, especially talc, can show up on the mammogram as speckles and spots that may obscure something important.

Can I just remove my shirt for the exam?
Yes. At most clinics you are only asked to remove your top, so wear a pair of pants or a skirt so that you don’t have to undress completely.

How long does having a mammogram last?
The whole process usually takes about 20 minutes. Your breast will be compressed for a minute or so, even though the x-ray takes only a few seconds. The technician has to step out of the room, just like when you get dental x-rays. The technician steps out of the room because otherwise she would be exposed to radiation all day, day in and day out.

If you have breast implants already your mammogram may take longer because the technician has to take more views and arrange you so that your implant is out of the way and your breast tissue is compressed properly between the plate.

What is the Eklund Technique? I have heard of this for women with breast implants.
The Eklund technique is the brainchild of G.W. Eklund, MD, Clinical Professor of Radiology at the Oregon Health Sciences University in Portland and a past president of the Society of Breast Imaging. He came up with a method of imaging a breast with an implant so that more of the natural breast tissue can be viewed. In this technique, breast tissue is pulled forward and away from the implants so that it can be compressed between the plates.

Mammogram and X-ray Films With Breast Implants

Leakage of silicone (between 11 and 12 o' clock position)

x-ray of normal breast implants

X-ray with normal implants (barely visible)

breast calcification with implant xray photo

X-ray with a calcified capsule of the right breast implant.

How will I know an irregularity is found?

Normally, the clinic will contact you within about two weeks, one way or the other. Some clinics have you fill out a postcard with your address and they then mail the card to you to tell you all is well. (They may also have you fill out a reminder card that they will send you when you are due for your next mammogram.) If there is an irregularity, they will call you. However, this does not mean that you should forget about it if you do not hear from them. Call the clinic and follow up on your own if you do not hear in a few weeks.

What happens if an irregularity is found?

Generally, you are called back in to have further mammography done. You may also have a breast ultrasound or MRI(magnetic resonance imaging) done. If these show the same irregularity, you may need to have a biopsy done. A biopsy is a procedure where a surgeon takes a small amount of tissue to see if it is cancerous or not. Often, the biopsy will show that the lump or whatever is benign. If it is not benign, you will sit down with a surgeon and discuss your options.

Mammogram Films Without Breast Implants


Macrocalcification of the breast	Benign cyst of the breast (rt)

Breast Self-Examination

At one time, breast self-examination (BSE) was strongly recommended as a way to help detect breast cancer in its earliest stages. The American Cancer Society now says that BSE is a good thing, but that it is not absolutely necessary. They now believe that regular mammography and an annual clinical breast examination (CBE) by a health professional are the best ways to detect breast cancer. However, the ACS also says that women should be aware of their breasts and that BSE is an option. Other groups still say that you should make BSE a monthly habit.

If you decide to do BSE, have your doctor or a nurse check your technique to ensure that you are doing it right. Over the years, the instructions for BSE have changed, so if you have already been doing BSE for years, you might need to update you technique. The ACS has an excellent website with BSE instructions and the Susan G. Komen for the cure has excellent instructions and visuals on BSE as well.

The take-away message here is that you have to get to know your breasts and how they look and feel so that you can tell if or when anything changes. If you have breast implants, have your doctor help you feel where the implants are so that you get to know how they feel. Take note of any discharge, changes in contour, color, lumps, firmness, pressure sensitivity, or anything else you find to odd and report to your physician immediately.

Magnetic Resonance Imaging

If you decide to have your breasts augmented with breast implants, you may be asked to undergo magnetic resonance imaging (MRI) of your breasts every few years. You may also need an MRI if anything suspicious is seen on a mammogram. An MRI is like an x-ray in that it is another type of medical imagining that is used to see what is going on in the body. Instead of using x-rays, an MRI uses magnetism to create detailed images of the inner structures of your body.

Because it uses very strong magnets, you should not have an MRI if there are any types of metal implants in your body. This includes metal plates or screws, artificial heart valves, pacemakers, cochlear ear implants, metal clips, or even metal chips from a car accident or bullet fragments, if you are unlucky enough to have those.

Getting an MRI is especially necessary if you decide to go with silicone implants see Your Options for Breast Augmentation. Currently, if you have silicone implants, it is recommended that you have an MRI done every few years to detect any rupture or leakage. Although, ruptures and leakage with silicone implants can be detected by standard x-ray mammograms, MRIs are significantly more successful at detecting them.

Some surgeons offer endoscopic inspection of the breast pocket and implant shell through a tiny incision on each breast if a rupture is suspected. The surgeon uses a fiber optic camera on the end of a small flexible wand to inspect the implant and its pocket to determine if there is a rupture or leakage and if there are any weaknesses in the implant and checks on the condition of the pocket.

The Least You Need to Know

Early detection of possible tumors, calcifications, cysts, etc. is the best way to defeat breast cancer.

Perform a Breast Self Exam every month, 3 days after the last day of your period. It is helpful to keep a journal for descriptions as well as reflecting back or recalling changes when discussing these issues with your physician.

breast cancer has been known to decrease in patients with breast cancer due to less blood supply to possible tumors. You see, implant exerts pressure on the tissue and glands of the breast and its subcutaneous tissue thereby reducing the oxygen rich blood that the cancer needs to replicate and destroy. In the rat model, specimens implanted with mammary prostheses, when seeded with cancer cells showed a significant decrease and even cessation of tumor growth.

If you are 35 and over (sometimes younger for some surgeon's wishes) you should be instructed by your surgeon pre-operatively to obtain a mammogram and report before any breast augmentation procedure is undergone.

Mammograms are usually started at 40 years of age and continue, yearly or no less that 1 every two years, for the length of the female patient's life.

Be aware that possible rupture of an implant is possible with mammography. The pressure exerted on the breast can eventually weaken the implant and you will more than likely be asked to sign a waiver noting this possibility/risk before the mammogram.

If you have a saline filled implant, the rupture should be noticed immediately although a small leak may take several hours. With silicone it is very gradual and may take years to notice. An MRI can detect leaking silicone filled implants. Although if the capsule is quite thick, as it is quite often, the free silicone remains undetectable.