Mammography: breast implants--types, complications, and adjacent breast pathology

Approximately 1.5 million women in the United States currently have breast implants. The majority were placed for cosmetic augmentation, but 20% were placed for reconstruction after the loss or deformity of a breast. The augmented breast is a challenge to the mammographer. Many of the palpable and mammographically detected abnormalities in these patients are related to the implant itself. Since, however, there is breast tissue present with cosmetic augmentation, the full range of fibrocystic and neoplastic conditions that can affect the breast may be seen. The presence of the implant makes imaging the breast more difficult because the implant obscures the nearby breast tissue. This paper reviews the history and evolution of various breast prostheses. The surgical approaches to placement of implants and complications associated with their use will be discussed. Examples of concomitant pathologies and a review of imaging strategies will be given.