Assessing Cancer Risk for Breast Implants
- “The Bachelor” star Clare Crawley, 44, had her breast implants removed partly because a mammogram revealed sacs of fluid hiding behind them.
- Breast implants can make it harder for mammography imaging to present breast tissue. However, extra imaging can be performed by alerting the technologist on hand you have implants.
- Concerns over breast implants and cancer risks are valid, but SurvivorNet experts say the risk is minimal.
- “Approximately 400,000 women” have implants each year. The incidence rate of these cancers is approximately “0.00075% or 1 in every 133,000 women,” Mount Sinai’s Dr. Sarah Cate, the lead physician for the Special Surveillance Breast Program at Mount Sinai Beth Israel, and Dr. Jordan Jacobs, a plastic and reconstructive surgeon tell SurvivorNet.
- The American Cancer Society says, “Studies show that silicone implants do not increase the risk of (tissue disease, breast cancer or reproductive problems).”
- The medical community has a broad consensus that women have annual mammograms between the ages of 45 and 54. However, if you have a higher risk for breast cancer due to a family history or a genetic mutation, you should consider screening at age 40.
- Our experts say anyone with breast implants should contact their physician if they experience breast swelling, pain, redness, tightening, or a change in the shape of their breasts.
Though she loved them, her annual mammograms became an unsettling reminder of the hidden risks. While Crawley has faced various health struggles, she has not been diagnosed with breast cancer. However, screenings revealed sacs of fluid behind her implants, pushing her to take action.
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Questions surrounding whether breast implants cause cancer have lingered for years. However, a report released by the U.S. Food and Drug Administration (FDA) on the issue says less than two dozen cases of skin and blood cancer are possibly linked to implants.
SurvivorNet experts Dr. Sarah Cate and Dr. Jordan Jacobs at Mount Sinai Health System in New York stress “just how small the incidence is” of these cancer-related cases compared to the total number of women receiving breast implants each year.
“There are approximately 400,000 women who have implants placed per year for either reconstructive or cosmetic purposes,” Dr. Cate and Dr. Jacobs told SurvivorNet. “If you consider a 10-year follow-up period, the incidence of these cancers is approximately 0.00075%. In other words, 1 in every 133,000 women,” Doctors Sarah Cate and Jordan Jacobs of Mount Sinai previously told SurvivorNet.
“It is not possible to conclude from this preliminary data that the cancers are definitively linked to breast implants,” Doctors Sarah Cate and Jordan Jacobs previously told SurvivorNet.
“My body is fighting them and recognizes it as something obviously foreign in my body,” Crawley said to People Magazine.
Crawley had her implants removed in 2021.
Expert Resources for Breast Cancer Screening
- 6 Common Excuses for Skipping a Mammogram That You Need to Stop Using!
- Earlier Mammograms for Black Women May Reduce Breast Cancer Mortality Disparity Rates By 57%; How to Screen for this Disease
- Mammograms Are Still the Best Tool for Detecting Breast Cancer — A Warning About Thermography
- Free Mammograms And Increased Access To Cancer Screenings Focus Of New Bills Promoting Early Detection
- I Have Dense Breasts. Do I Need a 3D Mammogram?
- New Guidelines Say Many Women Under 50 Can Skip Mammograms. That May Not Be The Best Advice
How Implants Impact Breast Cancer Screening?
According to the National Institutes of Health, a standard mammogram may not be as effective when screening for breast cancer where implants are involved. This is because the implants can mask breast tissue, making it harder to detect cancer.
“The presence of silicone gel-filled breast implants may interfere with standard mammography since silicone is radiopaque (difficult to see on an X-ray), and the physical presence of the implant compresses fat and glandular tissues, creating more homogeneous dense tissue that frequently lacks the contrast needed to detect subtle early features associated with breast cancer,” the NIH says.
WATCH: Understanding 3D mammography
To get a clearer picture of breasts with implants, enhanced mammography, such as a 3D mammogram, may be used.
RELATED: When Should I Get a Mammogram?
What to Know About Enhanced Mammograms
Enhanced mammograms are a helpful tool for women whose breast tissues obscure precise mammography readings. While implants often call for enhanced mammogram screening, women with dense breasts may also need enhanced screening. Dense breasts mean more fibroglandular tissue and less fatty breast tissue. During mammograms, the tissue difference can make locating signs of cancer more difficult in women with dense breasts.
Additional testing can be considered for dense breasts, depending on a woman’s personal history, preferences, and her physician’s guidance. These tests include:
- 3-D Mammogram (Breast Tomosynthesis): This technology acquires breast imaging from multiple angles and digitally combines them into a 3D representation of the breast tissue. This allows physicians to see breast tissue architecture better, even in dense breasts. 3D mammograms are fast becoming the standard way of performing mammography.
- Breast Magnetic Resonance Imaging (MRI): An MRI machine uses magnets to create highly detailed, intricate images of the breast. These are mostly reserved for women with an extremely high breast cancer risk. Dense breasts alone may not be a valid reason to obtain a breast MRI. However, dense breasts in women with genetic mutations, like BRCA1 and BRCA2, or a strong family history of breast cancer could justify obtaining breast MRIs.
- Molecular Breast Imaging (MBI): MBI is a newer imaging technique that uses a radioactive tracer to detect breast cancer. It is beneficial for women with dense breasts. However, MBI is not as widely available as other screening methods.
WATCH: When you’re getting a mammogram, ask about dense breasts.
The Food and Drug Administration implemented a rule that requires the mammography report to include a breast density assessment section. The report will have the following categories:
- “The breasts are almost entirely fatty.”
- “There are scattered areas of fibroglandular density.”
- “The breasts are heterogeneously dense, which may obscure small masses.”
- “The breasts are extremely dense, which lowers the sensitivity of mammography.”
The report will also explain if a woman’s breast tissue is dense, the dense breast tissue makes cancer more challenging to detect in a routine mammogram.
Understanding Your Mammogram Report
A radiologist reading mammograms categorizes breasts into four different categories using the Breast Imaging Reporting and Data System (BI-RADS), a classification system developed by the American College of Radiology (ACR). These include:
- Fatty breast tissue: These breasts are mainly fat with very little dense tissue. Found in less than 10% of women, fatty breasts appear dark on mammograms.
- Scattered fibroglandular breast tissue: These breasts contain a mix of fatty and dense tissue (composed of glands and fibrous tissue). On a mammogram, they have dark areas (fatty tissue) intermixed with light areas (dense tissue). Around 40% of women have breasts that fall in this category.
- Heterogeneously dense breast tissue: This type of breast tissue has many areas of dense tissue and some areas of fat. Found in 40% of women, these breasts look mostly light, with some dark areas on a mammogram.
- Extremely dense breast tissue: Such breasts are almost entirely composed of dense glandular and fibrous connective tissues with very little fat. They are found in 10% of women and appear light on mammograms.
Your breasts are usually called dense on a mammogram report if they fall within the heterogeneously dense breast tissue or the extremely dense breast tissue categories.
When to Screen for Breast Cancer
The medical community has a broad consensus that women have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should now start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives.
The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.
WATCH: Mammograms are still the best tool for detecting breast cancer.
Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Regular Self-Exams Are Helpful In Between Mammograms
A self-breast exam is an easy way to monitor your breasts for abnormalities. It involves feeling the breast for swelling, bulging, or changes in the shape of the breast or nipple.
WATCH: How to perform a self-exam.
Checking for signs of redness, rashes, or discharge is also part of this exam. If anything is found that is concerning, you should contact your doctor. It’s important to note that self-exams should be done with regular mammograms.
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