Breast implants make it more difficult to detect breast cancer on mammogram films, though they do not necessarily lead to later cancer diagnoses, according to a recent study. Radiologists have long known that breast implants obscure breast tissue on mammogram films, making them more difficult to spot cancer or other abnormalities.

In the study, Diana L. Miglioretti, Ph.D. of Group Health Cooperative, University of Washington, and colleagues compared the detection rates of breast cancer in women with and without breast implants. They found that breast implants decreased the sensitivity of mammography. That is, radiologists missed some breast abnormalities on mammogram films due to the implants. However, the researchers found that the implants did not lead to diagnoses of more advanced stages of breast cancer.

The American Society of Plastic Surgeons estimates that approximately 270,000 women underwent surgery to increase their breast size in 2002. The majority of women who undergo breast augmentation are between 19 and 34 years old.

Women may consider having their breasts enlarged for several different reasons:

• To make the breasts more proportionate with the body and enhance self-esteem
• To correct a reduction in breast volume after pregnancy
• To reshape or enlarge breasts that have lost their shape from breast-feeding or aging
• To balance asymmetrical breasts (breasts that differ significantly in size or shape)
• To reconstruct the breast contour after breast removal surgery (mastectomy)

Women with breast implants should follow the same program of recommended mammograms as women without breast implants (see below). The x-rays used for mammographic imaging of the breasts cannot penetrate silicone or saline implants well enough to image the overlying or underlying breast tissue. Therefore, some breast tissue (approximately 25%) will not be seen on the mammogram, as it will be covered up by the implant. In order to visualize as much breast tissue as possible, women with implants typically undergo additional mammogram views.

The U.S. National Cancer Institute mammography screening guidelines are as follows :

• All women 40 to 49 years of age should undergo mammography every one to two years.
• All women 50 years of age and older should undergo mammography every year.

Women 20 years of age and older are typically advised to receive regular physical breast exams,  performed by a healthcare provider, and practice monthly breast self-exams. In many cases, the earlier breast cancer is detected, the greater the chances that it can be successfully treated.

• The report, "Effect of Breast Augmentation on the Accuracy of Mammography and Cancer Characteristics," is published in the January 28, 2004 issue of the Journal of the American Medical Association, http://jama.ama-assn.org/
• To learn more about breast augmentation and other cosmetic or reconstructive procedures, please visit http://www.imaginis.com/breasthealth/menu-surgery.asp