Radiology Challenges with Breast Cancer Screening in Women with Breast Implants

Reportedly 365,000 people in the United States had breast augmentation procedures in 2021.¹ Emerging research comparing digital breast tomosynthesis (DBT) use in women with and without breast implants found a 22 percent lower cancer detection rate for women with breast implants. Yet there are currently no imaging guidelines specifically geared to breast cancer screening in patients with breast implants.

At the recent Society of Breast Imaging (SBI) conference, Stephen Rose, M.D, pointed out the breast implants may obscure between nine to 44 percent of glandular tissue on imaging. In a recent video interview, Dr. Rose said there are a number of factors, ranging from age of the implant and fibrosis to implant size, implant-related scarring and breast size, that can affect interpretation of breast imaging in patients with breast implants.

In retrospective research presented at the SBI conference, Dr. Rose and colleagues reviewed data from 350,845 DBT exams (including 20,929 DBT exams for women with breast implants) performed at 49 community-based outpatient imaging centers in 2019. In addition to the aforementioned lower cancer detection rate in women with implants, Dr. Rose and colleagues found that women with breast implants had a nearly 5.5 percent increase in ductal carcinoma in situ (DCIS) and a 4.8 percent higher incidence of positive lymph node involvement in detected cancers.

(Editor’s note: For related content, see “Breast Reconstruction: Current Principles and Emerging Concepts in Imaging” and ”Study Highlights Use of Contrast-Enhanced Mammography in Women with Breast Implants.”)

Has the time come for imaging guidelines that are more specific to the nuances and supplemental imaging needs for women with breast implants?

“Other than the same guidelines we use for women without breast implants, there really hasn’t been any specific guidelines by our societies that suggest doing more (for women with breast implants),” noted Dr. Rose, the founder and president of Rose Imaging Specialists. “It’s all been pretty anecdotal recommendations and it’s not like this is an insignificant number of patients. In some of our populations, 10 to 15 percent have implants.”

For more insights from Dr. Rose, watch the video below.

Reference

1. The Aesthetic Society. Aesthetic Plastic Surgery National Databank Statistics 2020-2021. Available at: https://cdn.theaestheticsociety.org/media/statistics/2021-TheAestheticSocietyStatistics.pdf . Accessed June 14, 2023.