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Mammograms in Singapore: What to know for women with breast implants

Breast cancer, which is the most common cancer among Singaporean women, accounts for nearly 30% of all female malignancies. It also has been the top female cancer for the last 30 years[1].

If you have breast implants, you might be wondering how your implants might affect your regular breast cancer screenings, or if you can still undergo a regular mammogram. 

Thankfully, you won’t need to remove your implants just to have a mammogram.

However, research shows that women with breast implants have a higher chance[2] of anaplastic large-cell lymphoma (ALCL), a type of non-Hodgkin’s lymphoma. That’s cancer that starts in your lymphatic system, which helps your body fight infection and disease.

How can you get a successful mammogram with breast implants and reduce your risk of breast implant cancer? Let’s find out. 

Can you still have a mammogram with breast implants?

If you are getting a breast cancer screening and you have breast implants, your doctor may have trouble spotting cancerous masses on your imaging scans. This is because the saline or silicone in breast implants can block parts of the breast during an X-ray.

Many medical facilities may not know how to properly scan for cancer in patients with implants. Fortunately, there are ways you can ensure a successful cancer screening. 

  • Research your clinic
    You can easily reduce your risk by choosing an experienced doctor who has handled other clients with breast implants. You’ll also want to know how your doctor or clinic obtains special mammogram views apart from their standard mammogram procedures. Your doctor needs to know two things well – how to position you, and how much compression to use.
  • Be open with the medical staff
    It is crucial that you inform your doctor and their team if you have breast implants. This will allow them to take extra safety precautions and do their utmost to conduct a successful screening for you. As an extra precaution, give your mammogram tech a heads up before your imaging procedure commences. An experienced technologist will know how to carefully compress your breasts without causing ruptures. 
  • Get a 3D mammogram
    A 3D mammogram will allow your doctor a clearer view of your breasts and will increase the chances of spotting any suspicious masses.
  • Get extra scans
    Extra imaging scans can help your doctors get a more comprehensive view and catch cancer in its early stages.
  • Always get checked
    If you’ve noticed lumps in your breast, they may be associated with your implant, and not necessarily with cancer. Get them checked anyway. Your doctor will help you decide if you require additional or alternative screening procedures.

What to expect at a mammogram if you have breast implants

While it is rare, breast implants can rupture during a mammogram. This is generally associated with compression, but it can also happen during another procedure known as a needle biopsy.

If you have breast implants, expect these extra steps at your breast cancer screening for your safety:

Extra images taken

The typical mammogram comprises 2 views of each breast (total of 4 pictures). But those with breast implants may require additional views of each breast. These extra views are needed to detect cancers that might be obscured by their implants.

Your doctor might need implant displacement views

In which case, your breast will be drawn out, and your implant will be pushed toward the wall of your chest for better visualisation. Implant displacement views typically involve little compression – just enough to keep the breast still.

A needle biopsy may be needed

If your imaging scans are inconclusive, your doctor may conduct a needle biopsy to collect a sample from a lump in your breast. They will then study it to detect cancer. In rare instances, and depending on the location of the lump, needle biopsies can cause implant rupturing.

Additional screenings may be necessary

Ultrasounds are one way of screening women with a high risk of breast cancer, who have dense breast tissue, and who have breast implants. Do note that ultrasounds are not a substitute for mammography –mammography picks up potentially cancerous calcium deposits, while ultrasounds help reveal obscured masses.

Read: Is an ultrasound or mammogram better?

If you are worried about a possible implant rupture, speak with your doctor before undergoing your screening. Your doctor might suggest you undergo an MRI instead of a mammogram.

Mammogram screening of Breast Implant in Singapore

How different breast implants affect mammograms in Singapore

Type of breast implantWhat it isHow it affects breast cancer screening
Subglandular
(Placement)
Breast implants are placed above the muscle. This is most common.Subglandular implants potentially reduce your radiologist’s ability to interpret the mammogram, as not all the breast tissue can be visualised. 
The good news is that it can be moved aside to capture the image of the tissue behind. Not all technologists are able to do this proficiently.
Subpectoral
(Placement)
Breast implants are placed beneath the muscle.Subpectoral implants are less likely to interfere with your mammogram.
Silicone
(Material)
Silicone implants have been curated to feel more like a natural breast, and are softer to the touch than saline.
Silicone implants contain a thick silicone gel encased in a silicone shell.
It is not absorbable by the body.
Silicone gel implants can partially or totally obscure the breast and prevent a successful mammogram.
This depends on the size and the thickness of the implant, as well the type of X-ray used[3]. 
A silicone implant rupture could lead to changes in breast shape and size, increasing pain, firmness, swelling, and capsular contracture.
Saline
(Material)
Saline implants are usually firmer and can be safely absorbed by the body in case of a rupture.
Saline implants contain sterile salt water encased in a silicone shell.
The sterile saltwater that fills saline implants obstructs the view of breast tissue during a mammogram.

What can breast cancer feel like for those with breast implants?

It’s crucial to get screened for cancer if you have breast implants, especially since implants have been linked to cancer and other illnesses. And regardless of whether or not you have implants, self-examining your breasts could save your life. 

For those with implants, here are a few things to consider:

  • Do not examine your breasts while you’re still healing (up to 6 weeks post-op).
  • Do not examine your breasts when swollen or tender (eg. during menstruation).
  • Some implant placements can push out the breast tissue, which could make your self-examination easier. 

Look out for the following symptoms:

  • A painless, hard lump with irregular edges
  • Redness
  • Swelling
  • Dimpling or puckering of the skin
  • Changes to the nipple: inversion, discolouration, or discharge
  • Pain in your breast
  • Bruised skin

Breast implant cancer (BIA-ALCL) can also develop in scar tissue around an implant, or in the fluid between the scar tissue and implant. 

Fortunately, BIA is treatable. A mammogram or a needle biopsy can be used to diagnose breast implant cancer.

Women with breast implants deserve to stay safe and assured while undergoing breast cancer screening. Contact us today to get the care you need. 

References

  1. Jara-Lazaro, A. R., Thilagaratnam, S., & Tan, P. H. (2010). Breast cancer in Singapore: some perspectives. Breast Cancer (Tokyo, Japan), 17(1), 23–28. https://doi.org/10.1007/s12282-009-0155-3
  2. Pagán, C. N. (n.d.). Breast Implants: Can They Cause Cancer? WebMD. Retrieved May 19, 2022, from https://www.webmd.com/breast-cancer/guide/can-breast-implants-cause-cancer
  3. ‌Daskalaki, A., Bliznakova, K., & Pallikarakis, N. (2016). Evaluation of the effect of silicone breast inserts on X-ray mammography and breast tomosynthesis images: A Monte Carlo simulation study. Physica Medica: PM: An International Journal Devoted to the Applications of Physics to Medicine and Biology: Official Journal of the Italian Association of Biomedical Physics (AIFB), 32(2), 353–361. https://doi.org/10.1016/j.ejmp.2016.01.478

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