Breast implants and mammography

Another issue that was investigated with surveillance data from the FDA's adverse event reporting system was breast implant issues during mammography. Women with breast implants are at the same risk for breast cancer as other women [21], and are urged to undergo mammography. In the MAUDE database, the FDA identified 66 reported adverse events that described issues with mammography related to breast implants [22]. The majority of these reports, 41 of 66 (62.1%), described breast implant rupture suspected to have occurred during mammography. Other adverse events reported included crushing implants during mammographic compression, pain during mammo-graphy attributed to implants, inability to perform mammography because of capsular contracture or fear of implant rupture, and delayed detection of cancer attributed to implants. It is well known that 22-83% of mammographically visualizable breast tissue may be obscured by breast implants, because radio-dense silicone implants obscure glandular tissue [23], and special positioning of augmented breasts is required to maximize imaging [24].

Because FDA's study was based on surveillance data, it was not possible to determine the prevalence of problems for women with breast implants during mammography. This information would be important for informing all women of possible risks with breast implants, and especially those at higher risk for cancer because of family history or other risk factors, of the added difficulty of performing mammography with breast implants. Importantly, young women considering breast implants may not have experienced a mammogram and may not consider their future need for mammography when they are deciding to obtain breast implants.

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