Imaging of breast cancer after augmentation mammoplasty

Experience with mammography in patients with augmentation mammoplasty has been limited by the younger age of the patients and the bias of the physicians that mammography may be ineffective in imaging the breast with a prosthesis. With recent advances in imaging of the augmented breast and the increase in popularity of augmentation mammoplasty, more of these patients are undergoing mammography. We reviewed the mammograms and clinical history of 25 women with breast implants and breast cancer. Seven (28%) of the 25 women were asymptomatic and referred for screening mammography. Mammography or sonography was positive in 22 (88%) of the 25 women. There was no nodal involvement in 11 of 18 patients with infiltrating duct carcinoma, 5 women with intraductal carcinoma, and 2 women with lobular carcinoma in situ. In this study, women with implants who developed breast cancer presented with nodal metastases in only 28% of cases. Modified position views should be performed in all patients, and sonography may be helpful in evaluating palpable masses even when mammography is normal. Breast cancer can be detected in the augmented breast by mammography even if clinically occult.